AN APPROACH TO LOCAL ANESTHESIA AT FLEXIBLE BRONCHOSCOPY 

Shteyner Mikhail L'vovich, Doctor of medical sciences, endoscopist of the endoscope office, Samara City Hospital No.4 (125 Michurina street, Samara, Russia); associate professor, sub-department of surgery with a course of endoscopy of the Institute of Vocational Education, Samara State Medical University (89 Chapayevskaya street, Samara, Russia), E-mail: iishte@yandex.ru 

616.233-072.1-089.5-031.84 

10.21685/2072-3032-2020-3-3 

Background. At the present, Lidocaine is the leading and the safest local anesthetic for flexible bronchoscopy. However, there are possible systemic complications that necessitate the search for a more rational application scheme.
Materials and methods. The efficacy and safety of the author's method of local anesthesia were studied based on the results of 22273 flexible bronchoscopies (100.00 %). The method involves the use of a 5 % lidocaine solution applied to irrigate the vocal folds, carina bifurcation of the trachea and the upper lobes spurs.
Results. In all cases, reliable anesthesia of the vocal folds was achieved rather quickly: a bronchoscope was carried out through the glottis with virtually no cough. No medical complications due to the use of lidocaine in the declared dosage were noted.
Conclusions. The proposed approach to local anesthesia provides reliable suppression of the cough reflex when passing through tussogenic zones with a bronchoscope and, at the same time, does not cause any systemic complications. 

flexible bronchoscopy, local anesthesia 

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