Background: Flexible optical fiber bronchoscopy (FFB) is a visual airway tract examination for diagnostic and therapeutic purposes. This procedure often causes discomfort for patients, such as cough, breathlessness and pain. Lidocaine is a topical anesthetic premedication used in bronchoscopy. This study compared the use of lidocaine nebulization and lidocaine spray in inhibiting pain, cough and breathlessness in complexity of flexible fiber optic bronchoscopy.Methods: Pretest and posttest control group clinical study was conducted in patients prior to bronchoscopy at RSUD Dr. Moewardi from February to March 2020. The samples were taken by consecutive sampling technique, then randomly assigned into either lidocaine spray or nebulization. Cough and pain were assessed with VAS score while breathlessness was assessed with Borg score. The data were analyzed statically by using Chi-square test with P<0.05 was considered significantResults: Cough scores were -17.78±11.66 for nebulization and -8.33±6.18 for spray (P=0.005). Pain score were -16.67±11.38 and -9.44±7.25 for nebulization and spray respectively (P=0.045). Borg score obtained the scores for nebulization and 0.06±0.42 for spray (P=1.000).Conclusion: Both lidocaine nebulization and spray were effective in decreasing breathlessness during bronchoscopy. However, lidocaine nebulization was more effective in decreasing cough and pain.

Background:. Patients with chest tube have allodynia (pain from stimuli that is normally painless) and hyperalgesia (increased sensitivity to pain). Anesthetics has not been used routinely when removing chest tubes assuming that the procedure is brief and that the pain is short-lived, even though it could be the most painful part of chest tube procedures.Objective: This study compared the effectiveness of local anesthetic EMLA cream and subcutaneous infiltration of lidocaine to reduce pain of chest tube removal, 10 minutes after, and it’s effect on the patient's willingness to repeat the procedure.Method: A quasi-experimental clinical trial conducted on 28 patients undergoing chest tube removal at dr. Moewardi from September 2020. The EMLA group (n = 14) received 2 grams of topical EMLA cream applied 2 hours before chest tube removal. The lidocaine group (n = 14) received subcutaneous infiltration of 2% lidocaine 5 minutes before chest tube removal. Pain was measured by VAS pain before, during, and 10 minutes after the chest tube was removed, followed by filling out a willingness to repeat procedure questionnaire.Results: Topical EMLA cream was comparable to 2% lidocaine infiltration for reducing pain during chest tube removal (p = 0.679) and 10 minutes thereafter (p = 0.833). EMLA cream did not increase the patient's willingness to repeat the procedure (p = 0.815)Conclusion: Topical EMLA cream able to replace the subcutaneous infiltration of 2% lidocaine as a local anesthetic for chest tube removal but does not increase the patient's willingness to repeat the procedure.