Observation on clinical effects of endotracheal surface anesthesia with tetracaine under bronchoscopic direct vision combined with general anesthesia using a laryngeal mask in bronchoscopy

ZHOU Ying; SHU Tiankun; NIE Huiyong; WANG Shuang; QUAN Pei; HUANG Jing

doi:10.3969/j.issn.1674-3806.2025.09.11

Abstract：Objective To observe the clinical effects of endotracheal surface anesthesia with tetracaine under bronchoscopic direct vision combined with general anesthesia using a laryngeal mask in bronchoscopy.Methods A total of 160 patients who underwent elective bronchoscopy in NORINCO General Hospital from June 2024 to December 2024 were recruited and randomly divided into observation group(undergoing endotracheal surface anesthesia with tetracaine under bronchoscopic direct vision combined with general anesthesia using a laryngeal mask)and control group(undergoing endotracheal surface anesthesia with lidocaine under bronchoscopic direct vision combined with general anesthesia using a laryngeal mask)by using random number table method,with 80 patients in each group.The levels of heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO2)were compared between the two groups before anesthesia(T0),1 minute after the start of the examination(T,),5 minutes after the start of the examination(T2)and 2 minutes after the removal of the laryngeal mask(T3).The choking cough scores during examination,cough scores during anaesthetic awakening period,incidence of itching in the airway,and the dosages of etomidate and propofol mixed liquids and remifentanil were compared between the two groups.The occurrence of adverse reactions in the patients during anaesthetic awakening period was recorded.Results At the time points from T0 to T3,there were no significant changes in the levels of SpO2,MAP and HR in the observation group(P＞0.05),and the levels of MAP and HR in the control group showed a trend of first increasing and then decreasing(P＜0.05),while the level of SpO2 showed no significant changes(P＞0.05).At the time points of T,and T2,the levels of MAP and HR in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).The dosages of etomidate and propofol mixed liquids and remifentanil during the examination in the observation group were significantly less than those in the control group(P＜0.05).Compared with the control group,the observation group showed better choking cough condition during examination and better coughing condition during anaesthetic awakening period,and had a lower incidence of itching in the airway,with statistically significant differences between the two groups(P＜0.05).The incidence rates of hypertension and arrhythmia in the observation group were significantly lower than those in the control group(11.25％vs 26.25％,x2=5.932,P=0.015;10.00％vs 31.25％,x2=11.063,P=0.001).No hypoxemia or bronchospasm occurred in either group.Conclusion Endotracheal surface anesthesia with tetracaine under bronchoscopic direct vision combined with general anesthesia using a laryngeal mask can effectively inhibit cardiovascular stress responses and airway responses in bronchoscopy,reduce the incidence of adverse reactions during anaesthetic awakening period,and has clinical promotion and application value.