الفهرس 
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Abstract
SUMMARY AND CONCLUSION
T
he study was conducted at bronchoscopy unit in Ain Shams university Hospital, it was included 40 patients underwent fibrotheptic bronchoscopy, 20 of them received lidocaine spray as a conventional method and the other 20 receieved nebulized lidocaine under positive pressure by CPAP provided that there is no contraindication for fibreoptic bronchoscopy.
All the included patients were subjected to the detailed medical history taking, demographic data, clinical examination, laboratory investigations, Fiberoptic bronchoscopy (F.O.B) was done under local anaesthesia using nebulized lidocaine through CPAP.
This study was performed just to compare between the 2 methods of anasethesia as regards cough, gag reflexes, discomfort of the patient and the extra doses of lidocaine during bronchoscopy.
This study include 40 patients underwent FOB under local anaesthesia, half of them used nebulized lidocaine under positive pressure by CPAP. The comparison between the 2 groups held mainly on the presence of cough and gag reflexes the degree of discomfort of the patient during the procedure and the extra doses of lidocaine used during the procedure.
The results have found that There was a highly significant difference between both groups regarding; coughing during FOB, occurrence of gag reflex and discomfort during FOB being more commonly occurred in patients in group B (conventional method)in comparison to patients of group A (CPAP group).
Also, there was a significant difference between group A (CPAP group) and patients in group B(conventional method) as the former group needed less additional doses of lidocaine spray to complete the procedure, while there is a non significant difference between both groups as regard duration of FOB.
To our knowledge, no studies have done to assess benefits of using nebulized lidocaine through CPAP, which seems to be superior to nebulized lidocaine alone due to deep and rapid deposition of the anesthetic agent and decreases dose of lidocaine used, so obviating its adverse effects.
from the present study it is concluded that:
1The nebulized lidocaine is more effective than its spray specially if it is under positive pressure by CPAP.
2.No need of more doses of lidocine during the procedure.
3Decrease serum lidocaine level so decrease the liability of toxicity (Favorable safety profile.
4Better patient compliance during the procedure.
5Better assessment of the bronchoscopist