{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:09:20Z","timestamp":1780103360067,"version":"3.54.0"},"reference-count":11,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2019]]},"abstract":"<b><i>Background:<\/i><\/b> Comparative characteristics of the cricothyroid injection and spray-as-you-go methods for lidocaine administration during diagnostic flexible bronchoscopy are not clear. <b><i>Objectives:<\/i><\/b> Co-primary outcomes were comparison of cough count from bronchoscope introduction until reaching carina and operator-rated overall procedure satisfaction on a Visual Analogue Scale (VAS) between groups. Secondary outcomes were cumulative lidocaine dose, procedure duration, assistant-rated cough, willingness to return for repeat procedure, and procedural complications between groups. <b><i>Methods:<\/i><\/b> Consecutive subjects were randomized (1:1) to either the cricothyroid or the spray-as-you-go method for topical anesthesia to the vocal cords and trachea. All received nasal 2% lidocaine gel and pharyngeal 10% lidocaine spray. <b><i>Results:<\/i><\/b> A total of 500 subjects were randomized, and 495 subjects were analyzed (248 cricothyroid and 247 spray-as-you-go). Cough count until reaching carina (median [range]) was significantly lower (cricothyroid, 1 [0\u201310], and spray-as-you-go, 4 [0\u201330], <i>p<\/i> &#x3c; 0.0001) and operator-rated overall procedure satisfaction, VAS (mean \u00b1 standard deviation) (cricothyroid, 7.86 \u00b1 1.39 and spray-as-you-go, 6.86 \u00b1 1.59, <i>p<\/i> &#x3c; 0.0001) significantly greater in the cricothyroid group. Patient willingness to return for repeat procedure was greater (87.1 vs. 70.5%, <i>p<\/i> &#x3c; 0.001)) and cumulative lidocaine dose significantly lower (305.08 \u00b1 13.40 vs. 322.18 \u00b1 10.67 mg, <i>p<\/i> &#x3c; 0.001) in the cricothyroid group. Minor complications occurred in 6 patients in the cricothyroid group and 9 patients in the spray-as-you-go group. <b><i>Conclusion:<\/i><\/b> Cricothyroid lidocaine administration is associated with less cough and superior operator-rated procedure satisfaction during bronchoscopy at a lower cumulative lidocaine dose.<\/jats:p>","DOI":"10.1159\/000501563","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T21:01:07Z","timestamp":1569272467000},"page":"440-446","source":"Crossref","is-referenced-by-count":13,"title":["The Cricothyroid versus Spray-As-You-Go Method for Topical Anesthesia during Flexible Bronchoscopy: The CRISP Randomized Clinical Trial"],"prefix":"10.1159","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5330-6391","authenticated-orcid":false,"given":"Karan","family":"Madan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7979-6405","authenticated-orcid":false,"given":"Saurabh","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishkarsh","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiba\u00a0Kalyan","family":"Biswal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan","family":"Tiwari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Hadda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anant","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randeep","family":"Guleria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/LBR.0000000000000458"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM194809092391101"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-203618"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1990.tb14504.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.45.6.474"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.89877"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-014-1099-y"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_249_17"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-14-108"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/LBR.0000000000000448"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/BF03018854"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/501563","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/501563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:43:10Z","timestamp":1745422990000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000501563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2019,11,18]]}},"URL":"https:\/\/doi.org\/10.1159\/000501563","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]}}}