Comparing topical administration of lidocaine alone and in combination with alfentanil in children undergoing bronchoscopy

Abstract

Introduction: Airway surgery and endoscopy in pediatric patients are always associated with challenges in anesthesia management. Deep anesthesia is required for preventing patient bucking during the procedure but patient breath should be maintained; in this regard, a combination of general and topical anesthesia can be beneficial. There is also evidence of the peripheral effects of opioids. The main objective of this study is to compare using lidocaine topically alone and combined with alfentanil opioids with respect to the central effects of opioids. Methods: In this study, 40 ASA class I and II children, aged 1–6 years, who were candidates for flexible diagnostic bronchoscopy were divided into two groups through block randomization using the random number table after obtaining parents' consent in complete health conditions. In this clinical trial, for collecting the data a special data collection form was used at the bedside of patients undergoing bronchoscopy at Pediatric Medical Center in 2017. Data including demographic information (age, weight, gender), duration of anesthesia, blood pressure before and after drug administration, duration of bronchoscopy, and recovery time were recorded in a form. Findings: In terms of demographic variables, there were not any significant differences between the two studied groups, indicating that the groups were matched and randomized appropriately. Although there were not any significant differences between the two groups of using lidocaine alone and in combination with alfentanil in other variables, in the recovery time a significant difference was observed between the two groups, with a mean of 13.05 min in the lidocaine group and 18.75 min in the lidocaine combined with alfentanil group. Conclusion: Topical administration of opioid with lidocaine through bronchoscopy had no impact on blood pressure, heart rate, anesthesia duration, and the frequency of perioperative complications.

Analgosedation and anaesthesia for flexible bronchoscopy in children

“…Od neželjenih efekata daje hipotenziju, muku, povraćanje, bradiaritmije i glavobolju. U slučaju intoksikacije, nastaju parestezije, srčane aritmije, konvulzije, komatozno stanje i srčani zastoj 15,16 .…”