Toscano Edson M.D.; Zamboni, Mauro M.D.; Torquato, Emanuel M.D.; de Biasi, Paulo M.D.; Roriz, Walter M.D.Journal of Bronchology: July 1999 Original Article: PDF Only Free Abstract A procedure for bronehoscopy using bilateral superior laryngeal nerve blockade (BSLNB) associated with topical anesthesia of the trachea by transcricothyroid membrane puncture is presented. A prospective study of 163 patients (120 men and 43 women) having bronchoscopic examination for diagnostic or follow-up purposes was conducted over a 2-year period. One hundred twenty-eight examinations were performed with a flexible bronchoscope and 28 with a rigid bronchoscope; the other 7 patients had simultaneously both rigid and flexible bronchoscopy. Results provided from separate evaluations by the patient and the endoscopist were ranked in an analog-visual scale ranging from 0 to 10 and classified as poor (0 to 3). tolerable (4 to 6). good (6 to 8), and very good (9 to 10) according to the patients' tolerance and the level of difficulty encountered by the examiner. Bronchoscopy was successfully performed in all patients, although in 2 flexible bronchoscopies (1.2%) supplemental anesthesia with a 10% lidocaine spray into the oropharynx was required. Procedures, when evaluated by patients, were considered poor (2%). tolerable (11%). good (76%), and very good (11%). whereas the endoscopists' respective evaluations were 2.5%. 7%. 19%, 70.5%. Few complications such as small (less than 1 mL) punctiform tracheal bleeding and local hematomas were observed in 3% and 1.2%, respectively, whereas some patients complained of dysphagia (33%) and hoarseness (5%). which stopped after disappearance of anesthetic effects. We therefore conclude that BSLNB is safely achieved by this alternative procedure, technically easy to perform, and rapid, comfortable, and satisfying for both patients and endoscopists. © 1999 Lippincott Williams & Wilkins, Inc.