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    Topical Lidocaine Does Not Exaggerate Laryngomalacia in Infants During Flexible Bronchoscopy Under Propofol Anesthesia.

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    Fulltext not available
    Authors
    von Ungern-Sternberg, B.
    Trachsel, D.
    Zhang, Guicheng
    Erb, T.
    Hammer, J.
    Date
    2016
    Type
    Journal Article
    
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    Citation
    von Ungern-Sternberg, B. and Trachsel, D. and Zhang, G. and Erb, T. and Hammer, J. 2016. Topical Lidocaine Does Not Exaggerate Laryngomalacia in Infants During Flexible Bronchoscopy Under Propofol Anesthesia.. J Bronchology Interv Pulmonol. 23 (3): pp. 215-219.
    Source Title
    J Bronchology Interv Pulmonol
    DOI
    10.1097/LBR.0000000000000291
    ISSN
    1948-8270
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/74814
    Collection
    • Curtin Research Publications
    Abstract

    BACKGROUND: Topical lidocaine has been found to result in overestimation of the severity of laryngomalacia in infants undergoing flexible bronchoscopy under conscious sedation with midazolam and nalbuphine. This effect has never been confirmed and may depend on the level of sedation and the drugs used. We assessed the effect of topical lidocaine on laryngomalacia in infants undergoing flexible bronchoscopy under general anesthesia with propofol. MATERIALS AND METHODS: Thirteen infants with congenital stridor referred to diagnostic flexible video-bronchoscopy were studied under propofol anesthesia before and 3 minutes after topical lidocaine administration to the larynx at a dose of 3 mg/kg body weight. Laryngomalacia was scored using 60 seconds video recordings of the larynx before and after lidocaine administration in random order by 2 independent blinded observers using the previously described arytenoid score (AS), epiglottis score (ES), and the total score (TS=AS+ES). RESULTS: No significant differences in AS, ES, and laryngomalacia score were found between the prelidocaine and postlidocaine assessments by the 2 raters. The intraclass correlation coefficients were 0.995 (95% confidence interval, 0.986-0.998) and 0.975 (0.930-0.991) and 0.989 (0.971-996) for AS, ES, and TS, respectively. CONCLUSIONS: The assessment of laryngomalacia is not affected by topical lidocaine under propofol anesthesia. The lidocaine effect on laryngomalacia may vary depending on the medication regime used and the depth of procedural sedation.

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