Maria Dewi Caetline, 2024, Thesis. The Effect of Dexmedetomidine and Lidocaine Inhalation as Bronchoscopy Premedication on Pain Scale, Cough Degree, Dyspnea, and Mean Arterial Pressure. Supervisor I: Dr. Yusup Subagio Sutanto, dr., Sp.P(K), FISR, FAPSR; Supervisor II: Dr. dr. Purwoko, Sp. An-TI, Subsp. An. O(K), Subsp. An. KV(K). Pulmonology and Respiratory Medicine Recidency Program, Medical Faculty, Sebelas Maret University, Surakarta

ABSTRACT

THE EFFECT OF DEXMEDETOMIDINE AND LIDOCAINE INHALATION AS BRONCHOSCOPY PREMEDICATION ON PAIN SCALE, COUGH DEGREE, DYSPNEA, AND MEAN ARTERIAL PRESSURE

Maria Dewi Caetline, Yusup Subagio Sutanto, Purwoko

Departement of Pulmonology and Respiratory Medicine Medical Faculty of Sebelas Maret University/Dr. Moewardi General Hospital Surakarta

Background: Flexible bronchoscopy is an invasive procedure using a flexible tube with light and video camera for diagnostic and therapeutic purposes. Dexmedetomidine has the benefits of sedation, sympatholysis, analgesic and low risk of respiratory depression. Lidocaine is able to block the autonomic nerves that deliver the sensation of pain. The aim of this study was to analyse the effect of dexmedetomidine and lidocaine inhalation as bronchoscopy premedication on the assessment of pain, cough, shortness of breath and mean arterial pressure.

Methods: Clinical research with quasi pretest-post-test control group design on pulmonary patients who performed bronchoscopy at RSUD Dr Moewardi Surakarta in January 2024 by consecutive sampling. The subjects were divided into treatment groups with inhalation with dexmedetomidine and lidocaine, dexmedetomidine alone, and lidocaine alone. Borg scale of breathlessness, VAS score of cough, VAS score of pain and MAP measurements at the time before and after bronchoscopy in both groups.

Results: A total of 51 pulmonary patient subjects who underwent bronchoscopy participated in this study. The dexmedetomidine and lidocaine combination group showed an increase in pain VAS scale (0.59 ± 7.48), cough VAS scale (0.59 ± 9.66), shortness of breath Borg scale (0.09 ± 0.83) and a decrease in MAP (3.41 ± 13.51) there was a significant difference compared to lidocaine control and dexmedetomidine alone group (p ≤ 0.005). The difference between the combination of dexmedetomidine and lidocaine and between the lidocaine control group and dexmedetomidine alone was statistically significant (p ≤ 0.005).

Conclusion: The administration of dexmedetomidine inhalation with lidocaine worked better to prevent the increase of VAS Pain scale, VAS cough scale, Borg breathlessness scale. However, there was no significant difference in MAP measurement.

Keywords: dexmedetomidine inhalation, lidocaine inhalation, bronchoscopy, Borg scale of dyspnea, VAS score of cough, VAS score of pain, mean arterial pressure