An assessment of prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine

Abstract

We have evaluated prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine in terms of efficacy and safety. Forty patients were included in a randomised double-blind parallel-group study. Efficacy was assessed using visual analogue scales, a patient ranking scale and the number of doses of local anaesthetic and intravenous sedative required. Measures of toxicity included peak plasma concentration of local anaesthetic, whether supplementary oxygen was needed and change in methaemoglobin concentration. For most of the outcome variables, the medians and quartiles were similar for the two local anaesthetics. However, the median peak plasma concentration of prilocaine (0.5 micrograms.ml-1) was less than one-third that of lidocaine (1.76 micrograms.ml-1). The merits and hazards of using multiple-regression modelling to improve the precision of the analysis of the results are considered. We conclude that prilocaine can be used successfully as a topical anaesthetic agent for fibreoptic bronchoscopy and is associated with a lower risk of toxicity.

Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations

“…[138139] Comparative studies of different topical agents are limited by small sample sizes; two RCTs compared lignocaine with cocaine and prilocaine, and found them both to be as efficacious as lignocaine. [140141]…”

Wskazówki Polskiego Towarzystwa Chorób Płuc dotyczące metod pozyskiwania, opracowywania oraz oceny płynu z płukania oskrzelowo-pęcherzykowego (BAL)

“…Inne środki znieczulenia miejscowego, takie jak: kokaina, tetrakaina lub prilokaina, obecnie stosuje się bardzo rzadko. W przypadku konieczności ich użycia nie należy przekraczać dawki kokainy 3 mg/kg masy ciała lub tetrakainy 0,2 mg/kg masy ciała do łącznej dawki 20 mg [39].…”