For A More Comfortable Bronchoscopy: Is Spray Catheter The Answer?

NCT ID: NCT02372760

Last Updated: 2015-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2015-12-31

Brief Summary

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Bronchoscopy is a commonly performed procedure for inpatients to visualize the airways when indicated. It is routinely done for both diagnostic (to lavage and biopsy the respiratory tract) and therapeutic purposes (to relief an obstruction or remove foreign bodies). Given the possible side effects of cough of varying severity this procedure can be uncomfortable to patients, some would even shy away from having a bronchoscopy even when it's medically indicated.

Recently a spray catheter was designed to deliver more uniform anesthesia to the airways as compared to the conventional way of injecting the anesthesia into the bronchoscopy working channel. The investigators aim to conduct this study with the hope of improving patient care, providing comfortable procedures, helping more patients opt in for bronchoscopy when indicated.

Detailed Description

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Bronchoscopy is a commonly performed procedure for inpatients. It is routinely done for both diagnostic and therapeutic purposes. The physician in this procedure inserts the bronchoscopy tube that has a camera at its tip to visualize the airways and detect possible pathologies. When needed, he/she can take samples (biopsies), perform brochoalveolar lavage, remove foreign bodies, or relieve airway obstructions.

The usual method of Bronchoscopic Anesthesia (BA) is conscious sedation combined with local anesthesia as it's more comfortable for the patients, with less chances of lidocaine toxicity. Local anesthesia is classically done using lidocaine injected through the bronchoscope's working channel. As the operator starts from the upper airway, they anesthetize each part as they go down to examine the lungs. The lidocaine will be delivered to the airway as it drips out of the working channel into the airway part closest to it. Side effects of this method is cough with varying frequencies/severity that may sometimes hinder the procedure.

Recently, a spray catheter was designed and used, but mainly for EBUS (Endobronchial Ultrasound) and not for bronchoscopy.

Conditions

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Airway Complication of Anaesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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BA by spray catheter (Olympus PW-205V)

This group will be having the bronchoscopic anesthesia (lidocaine) injected through the spray catheter (Olympus PW-205V).

Group Type EXPERIMENTAL

BA by spray catheter (Olympus PW-205V)

Intervention Type DEVICE

This group will be having the bronchoscopic anesthesia (lidocaine) injected through the spray catheter (Olympus PW-205V)

Anesthesia

Intervention Type DRUG

Both groups will receive lidocaine as the anesthesia for bronchoscopy

BA classic anesthesia

This group will be having the bronchoscopic anesthesia (lidocaine) injected through the bronchoscope's working channel.

Group Type ACTIVE_COMPARATOR

BA classic anesthesia

Intervention Type OTHER

This group will have the bronchoscopic anesthesia (lidocaine) injected through the bronchoscope's working channel.

Anesthesia

Intervention Type DRUG

Both groups will receive lidocaine as the anesthesia for bronchoscopy

Interventions

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BA by spray catheter (Olympus PW-205V)

This group will be having the bronchoscopic anesthesia (lidocaine) injected through the spray catheter (Olympus PW-205V)

Intervention Type DEVICE

BA classic anesthesia

This group will have the bronchoscopic anesthesia (lidocaine) injected through the bronchoscope's working channel.

Intervention Type OTHER

Anesthesia

Both groups will receive lidocaine as the anesthesia for bronchoscopy

Intervention Type DRUG

Other Intervention Names

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Spray catheter Lidocaine

Eligibility Criteria

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Inclusion Criteria

* Adult patients (18 years of age and above)
* Not mechanically ventilated
* Needing a bronchoscopy as determined by a referring or consulting physician/medical service

Exclusion Criteria

* Individuals below 18 years of age
* Pregnant women
* Terminally-ill patients
* Patients who are unable to consent in person
* Patients with contraindications for bronchoscopy (according to British Thoracic Society 2013 Guidelines this includes patients with acute myocardial infarction and patients in acute respiratory distress)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Adil Shujaat, MD

Role: PRINCIPAL_INVESTIGATOR

University at Buffalo

Locations

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UF Health

Jacksonville, Florida, United States

Site Status

Countries

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United States

References

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Stolz D, Chhajed PN, Leuppi J, Pflimlin E, Tamm M. Nebulized lidocaine for flexible bronchoscopy: a randomized, double-blind, placebo-controlled trial. Chest. 2005 Sep;128(3):1756-60. doi: 10.1378/chest.128.3.1756.

Reference Type BACKGROUND
PMID: 16162784 (View on PubMed)

De S. Assessment of patient satisfaction and lidocaine requirement during flexible bronchoscopy without sedation. J Bronchology Interv Pulmonol. 2009 Jul;16(3):176-9. doi: 10.1097/LBR.0b013e3181afca25.

Reference Type BACKGROUND
PMID: 23168547 (View on PubMed)

Jakobsen CJ, Ahlburg P, Holdgard HO, Olsen KH, Thomsen A. Comparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia. Acta Anaesthesiol Scand. 1991 Apr;35(3):238-41. doi: 10.1111/j.1399-6576.1991.tb03280.x.

Reference Type BACKGROUND
PMID: 2038931 (View on PubMed)

Antoniades N, Worsnop C. Topical lidocaine through the bronchoscope reduces cough rate during bronchoscopy. Respirology. 2009 Aug;14(6):873-6. doi: 10.1111/j.1440-1843.2009.01587.x.

Reference Type BACKGROUND
PMID: 19703068 (View on PubMed)

Lee HJ, Haas AR, Sterman DH, Solly R, Vachani A, Gillespie CT. Pilot randomized study comparing two techniques of airway anaesthesia during curvilinear probe endobronchial ultrasound bronchoscopy (CP-EBUS). Respirology. 2011 Jan;16(1):102-6. doi: 10.1111/j.1440-1843.2010.01861.x.

Reference Type BACKGROUND
PMID: 20920136 (View on PubMed)

Kenzaki K, Hirose Y, Tamaki M, Sakiyama S, Kondo K, Mutsuda T, Monden Y. Novel bronchofiberscopic catheter spray device allows effective anesthetic spray and sputum suctioning. Respir Med. 2004 Jul;98(7):606-10. doi: 10.1016/j.rmed.2004.01.002.

Reference Type BACKGROUND
PMID: 15250225 (View on PubMed)

Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, Lamb C, Silvestri GA. American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest. 2011 Nov;140(5):1342-1350. doi: 10.1378/chest.10-3361.

Reference Type BACKGROUND
PMID: 22045879 (View on PubMed)

Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, Mandal S, Martin J, Mills J, Navani N, Rahman NM, Wrightson JM, Munavvar M; British Thoracic Society Bronchoscopy Guideline Group. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax. 2013 Aug;68 Suppl 1:i1-i44. doi: 10.1136/thoraxjnl-2013-203618. No abstract available.

Reference Type BACKGROUND
PMID: 23860341 (View on PubMed)

Other Identifiers

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UFJ 2014-47

Identifier Type: -

Identifier Source: org_study_id