Impact Of Different Anesthesia Methods On Post-flexible Bronchoscopy Fever

Objective and significance:The provision of moderate sedation and topical anesthesia for fiberoptic bronchoscopy(FB)has become the current mainstream,but some potential risks can not be ignored.Such as sedative state,due to cough reflex is suppressed,reduced cough times make sputum,oropharyngeal secretions,check the additional local anesthetic and rinse can not be discharged from the respiratory tract,which undoubtedly increased the postflexible bronchoscopy fever.In addition,the cricothyroid membrane puncture surface anesthesia with a good local anesthesia effect is widely used in the FB,but this is an invasive technology with risk of bleeding and tracheal mucosal injury,induce inflammation and secondary infection,which may increase the chances of fever.Post-flexible bronchoscopy fever often occurs,but there is no related reports about the impact of anesthesiaon post-flexible bronchoscopy fever.In this study,we are going to investigate the effects of different anesthetic methods on post-flexible bronchoscopy fever.To clear the impact of moderate sedation measures and cricothyroid puncture anesthesia on post-flexible bronchoscopy fever.Experiment 1.A comparion of post-flexible bronchoscopy fever between the topical anesthesia and the combination of moderate sedation and topical anesthesia.Objective: To observe the impact of moderate sedation on post-flexible bronchoscopy fever.Methods:Patients were divided into two groups: moderate sedation and topical anesthesia group(group A)and topical anesthesia group(group B).In Group A,all patients retain spontaneous breathing with topical anesthesia,moderate sedation undergoing bronchoscopy.In group B,patients were applied with airway surface topical anesthesia undergoing bronchoscopy.The primary outcome measure was the incidence of fever.Secondary outcome parameters were vital parameters(T1 was the before the examination,T2 was the check of the carina,and T3 was the end of the examination),frequency of cough,the satisfaction of treating physician and the patient.Result: The incidence of post bronchoscopy fever did not differ between the two groups(20% for the group A vs.15% for group B,P > 0.05).;there was no significant difference in peak body temperature,onset of fever,duration of fever(P > 0.05);At T2 points,HR of group A was significant difference with group B(p<0.05);There was no significant difference in Sp O2 between the two groups at T1,T2 and T3(P > 0.05);At T2 and T3 points,MAP of group A was significant difference with group B(p<0.05);The total number of coughs was significantly less in the group A compared with group B(p<0.05);The patients’ VAS for symptoms and the endoscopists’ evaluation showed a significant overall inclination for group A.Conclusion:Moderate sedationdoes not increase the risk of post-flexible bronchoscopy fever,and the approach provides good patient and physician satisfaction.Experiment 2.A comparion of post-flexible bronchoscopy fever between two topical anesthesia methods.Objective: To observe the effect of transtracheal Injection on post-flexible bronchoscopy fever.Methods:Patients were randomized into two groups:transcricoid group(group C)were offered local anesthetic by transcricoid injection(cricothyroid puncture),spray group(group D)were offered local anesthetic by a laryngo-tracheal mucosal atomization.After obtaining an adequate surface anesthesia,intravenous infusion of remifentanil and propofol slowly(TCI),the endoscopic doctor started checking until patient loss of consciousness.The primary outcome measure was the incidence of fever.Secondary outcome parameters were vital parameters,frequency of cough,the satisfaction of treating physician and the patient.Results:Analysis of group C and group D,there was no significant difference in post-FB fever,peak body temperature,onset of fever,duration of fever(P > 0.05);There was no significant difference in vital signs between the two groups;The patients’ VAS for symptoms and the endoscopists’ evaluation showed a significant overall inclination for group C;The total number of coughs was significantly less in the group C compared with group D(p<0.05);In addition,the amount of Remifentanil used in group C was less than group D(p<0.05).Conclusion:Transcricoid injection(cricothyroid puncture)does not increase the frequency of post-FB fever,and the approach provides good patient and physician satisfaction.Moderate sedation and transcricoid injection method does not increase the risk of post-flexible bronchoscopy fever,the approach provides good patient and physician satisfaction.It also provides a better anesthetic effect for flexible bronchoscopy.