Adjustment of anesthesia method

Oct 13, 2025 by wbrum.org 63 views

Introduction

Bronchoscopy of flexible optical fiber is a crucial medical procedure for diagnosing and treating lung diseases. Patient comfort is a vital factor that must be considered during this procedure. The aim of this study is to compare the level of comfort of patients undergoing bronchoscopy with two local anesthesia methods: spray and nebul, in the Integrated Diagnostic Installation Room (IDT) of H. Adam Malik Hospital Medan.

Bronchoscopy is a minimally invasive procedure that involves inserting a flexible tube with a camera and light on the end into the lungs to visualize the airways and diagnose various lung conditions. Patient comfort is essential during this procedure to ensure that the patient remains calm and cooperative, which is critical for the success of the procedure. Local anesthesia is commonly used to reduce discomfort and anxiety during bronchoscopy.

Research Methods

This study is an experimental quasi-experimental study with a sample of 64 patients undergoing flexible optical fiber bronchoscopy. The sample is divided into two groups: the spray anesthesia group and the nebul anesthesia group. Before the procedure, each patient is given a diazepam 5 mg intramuscular premedication three hours before the procedure and atropine sulfas 0.25 mg subcutaneous 30 minutes before the procedure. During the procedure, the patient's condition is monitored using an oximeter. The amount of cough that occurs during bronchoscopy is recorded, and after the procedure, the patient is asked to assess the level of discomfort using Visual Analogue Scale (VAS).

The study design is a quasi-experimental study, which means that it is an experimental study without randomization. The sample size is 64 patients, which is a relatively small sample size. The study uses a pre-post design, where the patients are assessed before and after the procedure.

Research Results

Of the 64 patients studied, 32 patients receive anesthesia with spray, while 32 other patients use nebul. The results of the analysis show that there is a significant difference in the use of lidocaine between the two groups (p = 0.002), where the nebul group uses fewer lidocaine (an average of 170.94 mg) than the spray group (an average of 204.38 mg). However, the success rate of anesthesia in both groups does not show a significant difference (p = 0.516).

The cough frequency is also recorded, with the spray group having a cough frequency between 0 to 10 times, while the nebul group is between 0 to 9 times. The average VAS value for discomfort in the spray group is 1.60 cm and in the nebul group is 1.65 cm (p = 0.288). The scale of discomfort shows that 68.75% of patients in the spray group felt a little or no unpleasant sensation (scale 1), while in the nebul group, 59.37% of patients felt the same thing (p = 0.325). The Wilcoxon test found no significant difference between the number of coughs (p = 0.375) and the VAS value (p = 0.410) in both groups.

Discussion

The results of this study show that both local anesthesia spray and nebul give a similar level of comfort to patients undergoing flexible optical fiber bronchoscopy. This suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure. The study also found that the use of lidocaine is significantly different between the two groups, with the nebul group using fewer lidocaine than the spray group.

The study has some limitations, including the small sample size and the quasi-experimental design. However, the study provides valuable information on the comparison of patient comfort between local anesthesia spray and nebul in bronchoscopy.

Conclusion

In conclusion, this study found that both local anesthesia spray and nebul give a similar level of comfort to patients undergoing flexible optical fiber bronchoscopy. This suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure. This study is important for the development of operational standards in bronchoscopic procedures and can contribute to increasing patient experience in health services.

Recommendations

Based on the findings of this study, the following recommendations are made:

Use of nebul anesthesia: The study found that nebul anesthesia uses fewer lidocaine than spray anesthesia, which may be beneficial for patients who are sensitive to lidocaine.
Adjustment of anesthesia method: The study suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure.
Development of operational standards: The study highlights the importance of developing operational standards in bronchoscopic procedures to ensure that patients receive the best possible care.

Future Research Directions

Future research directions include:

Comparing different anesthesia methods: Future studies can compare different anesthesia methods, such as topical anesthesia and intravenous anesthesia, to determine which method is most effective for bronchoscopy.
Evaluating patient satisfaction: Future studies can evaluate patient satisfaction with different anesthesia methods to determine which method is most preferred by patients.
Developing new anesthesia methods: Future studies can develop new anesthesia methods that are more effective and safer for patients.

Limitations of the Study

The study has some limitations, including:

Small sample size: The study has a small sample size, which may limit the generalizability of the findings.
Quasi-experimental design: The study uses a quasi-experimental design, which may limit the internal validity of the study.
Limited outcome measures: The study uses limited outcome measures, such as cough frequency and VAS value, which may not capture the full range of patient outcomes.

Implications for Practice

The study has implications for practice, including:

Use of nebul anesthesia: The study suggests that nebul anesthesia may be a beneficial option for patients undergoing bronchoscopy.
Adjustment of anesthesia method: The study suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure.
Development of operational standards: The study highlights the importance of developing operational standards in bronchoscopic procedures to ensure that patients receive the best possible care.

Implications for Future Research

The study has implications for future research, including:

Comparing different anesthesia methods: Future studies can compare different anesthesia methods to determine which method is most effective for bronchoscopy.
Evaluating patient satisfaction: Future studies can evaluate patient satisfaction with different anesthesia methods to determine which method is most preferred by patients.
Developing new anesthesia methods: Future studies can develop new anesthesia methods that are more effective and safer for patients.

Q: What is bronchoscopy and why is patient comfort important during the procedure?

A: Bronchoscopy is a medical procedure that involves inserting a flexible tube with a camera and light on the end into the lungs to visualize the airways and diagnose various lung conditions. Patient comfort is essential during this procedure to ensure that the patient remains calm and cooperative, which is critical for the success of the procedure.

Q: What are the two local anesthesia methods used in this study?

A: The two local anesthesia methods used in this study are spray anesthesia and nebul anesthesia. Spray anesthesia involves spraying a local anesthetic directly onto the airways, while nebul anesthesia involves inhaling a local anesthetic through a nebulizer.

Q: What were the results of the study in terms of patient comfort?

A: The study found that both local anesthesia spray and nebul give a similar level of comfort to patients undergoing flexible optical fiber bronchoscopy. This suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure.

Q: What were the results of the study in terms of cough frequency?

A: The study found that the cough frequency was similar between the two groups, with the spray group having a cough frequency between 0 to 10 times, while the nebul group is between 0 to 9 times.

Q: What were the results of the study in terms of VAS value for discomfort?

A: The study found that the average VAS value for discomfort in the spray group was 1.60 cm and in the nebul group was 1.65 cm (p = 0.288). The scale of discomfort shows that 68.75% of patients in the spray group felt a little or no unpleasant sensation (scale 1), while in the nebul group, 59.37% of patients felt the same thing (p = 0.325).

Q: What are the implications of this study for clinical practice?

A: The study suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure. This study is important for the development of operational standards in bronchoscopic procedures and can contribute to increasing patient experience in health services.

Q: What are the limitations of this study?

A: The study has some limitations, including the small sample size and the quasi-experimental design. However, the study provides valuable information on the comparison of patient comfort between local anesthesia spray and nebul in bronchoscopy.

Q: What are the future research directions based on this study?

A: Future research directions include comparing different anesthesia methods, evaluating patient satisfaction with different anesthesia methods, and developing new anesthesia methods that are more effective and safer for patients.

Q: What are the implications of this study for patient care?

A: The study highlights the importance of considering patient comfort during bronchoscopy and suggests that the choice of anesthesia method can be adjusted to the patient's needs without sacrificing comfort during the procedure.

Q: What are the implications of this study for healthcare providers?

A: The study suggests that healthcare providers should consider the patient's needs and preferences when choosing an anesthesia method for bronchoscopy and should be aware of the potential benefits and limitations of each method.

Q: What are the implications of this study for healthcare policy?

A: The study highlights the importance of developing operational standards in bronchoscopic procedures to ensure that patients receive the best possible care and suggests that healthcare policy should prioritize patient comfort and satisfaction during medical procedures.

Q: What are the implications of this study for future research?

A: The study suggests that future research should focus on comparing different anesthesia methods, evaluating patient satisfaction with different anesthesia methods, and developing new anesthesia methods that are more effective and safer for patients.