1% Tetracaine hydrochloride injection pure solution aerosol inhalation combined with oral administration of dyclonine hydrochloride mucilage as upper airway anesthesia for bronchoscopy: A randomized controlled trial

Abstract

Background: During the bronchoscopy process, successful passage of the tracheoscope through the glottis can affect the following procedure of bronchoscopy. Therefore, safer, more effective and less painful anesthesia methods are particularly important for the bronchoscopy success rate. Objective: This study aimed to evaluate the efficacy of 1% tetracaine hydrochloride injection pure solution aerosol inhalation combined with oral administration of dyclonine hydrochloride mucilage during bronchoscopy. Methods: Patients who need bronchoscopy or bronchoscope treatment were randomly assigned to two groups; group A received pure tetracaine hydrochloride injection solution (3 mL of 1% tetracaine hydrochloride) aerosol inhalation combined with oral 5 mL of dyclonine hydrochloride mucilage and group B received diluted tetracaine hydrochloride injection (3 mL of 1% tetracaine hydrochloride injection + 3 mL of sterile water for injection) aerosol inhalation combined with oral 5 mL of dyclonine hydrochloride mucilage. The anesthetic effect and adverse reactions of these groups were observed and compared. Result: A total of 523 patients were randomized. The results showed that patient's tolerance, cough response, glottis opening during the bronchoscope into the glottis and the time required to the tracheoscope pass through the glottis were obviously significantly better in group A than in group B. Vital signs including blood pressure, heart rate and pulse oxygen saturation were more stable in group A than in group B. Conclusion: The 1% tetracaine hydrochloride injection pure liquid aerosol inhalation combined with oral administration of dyclonine hydrochloride mucilage as upper airway anesthesia is effective and safe for bronchoscopy. This method of local anesthesia is worthy of clinical application. K E Y W O R D Saerosol inhalation, bronchoscopy, local anesthesia, tetracaine hydrochloride injection | 133 WANG et Al.

Disturbance of consciousness caused by dyclonine hydrochloride mucilage: a case report

“…Dyclonine hydrochloride mucilage can reduce throat spasm, eliminate mucus bubbles in the oropharyngeal cavity, and produce a defoaming effect in the gastric cavity, thereby improving the field of vision during electronic gastroscopy [ 6 ]. Further, numerous studies have confirmed better efficacy and safety compared to lidocaine and tetracaine for gastrointestinal endoscopy and tracheal intubation [ 2 , 7 ].…”

Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report

“…[ 9 ] Advising patients to use a precontained dacronine gelatin paste and administering intravenous remimazolam and a 5 mL topical spray of 2% lidocaine in the oropharynx prior to induction resulted in smoother hemodynamics during induction. [ 1 ] In this case, we chose remimazolam sedation with mild respiratory inhibition. We used full epineural anesthesia to enhance the patient’s tolerance to LMA placement, reduced the dosage of remimazolam, and avoided excessively deep anesthesia to prevent aggravating the inhibition of voluntary respiration.…”

“…Literature suggests that combining pharyngeal surface anesthesia with remimazolam sedation results in smoother hemodynamics during induction. [ 1 ] In this case, we propose a new approach to general anesthesia using a laryngeal mask with preservation of spontaneous respiration, pharyngeal mucosal surface anesthesia, and thoracic paravertebral nerve block (TPVB) combined with remimazolam sedation. This approach aims to provide precise analgesia, moderate sedation, and successful LMA general anesthesia to preserve spontaneous respiration in patients undergoing thoracoscopic pulmonary wedge resection.…”