Comparison of Nebulized Lidocaine and Intratracheally Injected (Spray-as-you-go) Lidocaine in Pain and Cough Reduction during Bronchoscopy

BACKGROUND: Patients undergoing bronchoscopy often suffer from pain, coughing, and suffocation. Therefore, lidocaine is prescribed through various methods to induce local anesthesia. This study aimed to compare nebulized lidocaine and intratracheally injected lidocaine in pain and cough reduction during bronchoscopy. MATERIALS AND METHODS: This clinical trial was performed on 96 patients, divided into two groups of intervention (receiving lidocaine via a nebulizer before bronchoscopy) and control (receiving lidocaine through the working channel of bronchoscope). Then, the patients᾽ cough frequency was recorded during the procedure, and the pain level was measured using a numerical rating scale at the end of the procedure. The data were analyzed with SPSS software (version 16) using the chi-square and Fisher's exact tests. Moreover, the linear and Poisson regression tests were applied to analyze the main variables in this study. RESULTS: There was no significant difference between the two groups regarding demographic characteristics (P>0.05). Moreover, the linear regression test revealed that the intervention (nebulized lidocaine) group had significantly lower pain scores (1.54±0.08) than the control (intratracheally injected lidocaine) group (2.5±0.26) (P=0.013). In addition, the Poisson regression test showed a statistically significant difference between the intervention (35.22±2.93) and control (48.85±5.96) groups in terms of cough frequency (P<0.0001). CONCLUSION: This study indicated that nebulized lidocaine has higher efficacy in reducing the patients᾽ pain and cough during bronchoscopy than intratracheally injected lidocaine.