Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 5108-5114
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5108
Evaluation of bronchoscopic direct vision glottis anesthesia method in bronchoscopy
Jie Lang, Zhi-Zhen Guo, Shu-Shan Xing, Jian Sun, Bin Qiu, Yu Shu, Zhi-Qiang Wang, Gui-Xiang Liu
Jie Lang, Jian Sun, Bin Qiu, Yu Shu, Zhi-Qiang Wang, Gui-Xiang Liu, Department of Thoracic Surgery, Tangshan People’s Hospital, Tangshan 063000, Hebei Province, China
Zhi-Zhen Guo, Department of Nephrology, Kailuan General Hospital, Tangshan 063000, Hebei Province, China
Shu-Shan Xing, Department of Oncology, Tangshan Central Hospital, Tangshan 063000, Hebei Province, China
Author contributions: Lang J, Xing SS concept and designed the study; Guo ZZ, Sun J, and Qiu B were be responsible for materials and patients; Shu Y, Wang ZQ, and Liu GX collected and analyzed the data; all authors wrote and approved the final manuscript.
Supported by Hebei Science and Technology Program, No. 162777232 (to Xing SS).
Institutional review board statement: This study was approved by the ethics committee of Tangshan People’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declared no conflicts of interest.
Data sharing statement: All datasets are available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Shan Xing, MD, Deputy Director, Department of Oncology, Tangshan Central Hospital, No. 601 Changning Road, Tangshan 063000, Hebei Province, China. xingshushan2022@163.com
Received: April 27, 2023
Peer-review started: April 27, 2023
First decision: June 1, 2023
Revised: June 6, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: July 26, 2023
Abstract
BACKGROUND

Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases. However, current anesthesia methods, such as spray, nebulized inhalation, and cricothyroid membrane puncture, have their own advantages and disadvantages. Recently, studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.

AIM

To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.

METHODS

The study included 100 patients who underwent bronchoscopy during thoracic surgery. A random number table method was used to divide the patients into control and observation groups (50 patients each). The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method, respectively. Hemodynamic indices [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and oxygen saturation (SpO2) before (T1), 5 min after anesthesia (T2), and at the end of the operation (T3)] serum stress hormone indices [norepinephrine (NE), epinephrine (E), adrenocorticotropic hormone (ACTH), and cortisol (Cor) before and after treatment] were compared between the 2 groups. Adverse effects were also compared between the two groups.

RESULTS

At T2 and T3, SBP, DBP, and HR were lower in the observation group than the control group, whereas SpO2 was higher than the control group [(119.05 ± 8.01) mmHg vs (127.05 ± 7.83) mmHg, (119.35 ± 6.66) mmHg vs (128.39 ± 6.56) mmHg, (84.68 ± 6.04) mmHg vs (92.42 ± 5.57) mmHg, (84.53 ± 4.97) mmHg compared to (92.57 ± 6.02) mmHg, (74.25 ± 5.18) beats/min compared to (88.32 ± 5.72) beats/min, (74.38 ± 5.31) beats/min compared to (88.42 ± 5.69) beats/min, (97.36 ± 2.21)% vs (94.35 ± 2.16)%, (97.42 ± 2.36)% vs (94.38 ± 2.69%], with statistically significant differences (all P < 0.05). After treatment, NE, E, ACTH, and Cor were significantly higher in both groups than before treatment, but were lower in the observation group than in the control group [(68.25 ± 8.87) ng/mL vs (93.35 ± 14.00) ng/mL, (53.59 ± 5.89) ng/mL vs (82.32 ± 10.70) ng/mL, (14.32 ± 1.58) pg/mL vs (20.35 ± 3.05) pg/mL, (227.35 ± 25.01) nmol/L vs (322.28 ± 45.12) nmol/L], with statistically significant differences (all P < 0.05). The incidence of adverse reactions was higher in the control group than in the observation group [12.00% (12/50) vs 6.00% (3/50)] (P < 0.05).

CONCLUSION

The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress, with good safety and practicality.

Keywords: Direct bronchoscopy, Glottis anesthesia method, Bronchoscopy, Airway, Sedation

Core Tip: We evaluated the use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients, and found it was beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the patient stress level with good safety and practicality.