Predictors of pain control in patients undergoing flexible bronchoscopy

The purpose of this study was to assess the extent to which patients underg oing flexible bronchoscopy (FOB) experience pain and to identify patient fa ctors and process of care factors that are associated with pain. We conduct ed a prospective cohort study on 481 patients undergoing FOE. Overall contr ol of pain during FOE was the primary outcome. The mean age of the patients was 48 yr, 50% were male, and 32% required supplemental oxygen prior to FO E. Pain control was excellent in 36% of patients, but 10% considered it to be fair or poor. Patient factors associated with excellent pain control wer e excellent health (versus poor health, OR = 6.25 [95% CI, 2.28-16.67]), mo re education (college education versus high school education, OR = 1.72 [95 % CI, 1.05-2.86]), and not having asthma (OR = 2.86 [95% CI, 1.09-7.14]). P rocess of care factors associated with excellent pain control were not bein g bothered by scope insertion (versus bothered, OR = 3.65 [95% CI, 1.99-6.9 8]), no memory of FOE (versus some memory, OR = 2.33 [95% CI, 1.24-4.44]), and higher ratings of information about the procedure (per 1-point increase on a 12-point scale, OR = 1.57 [95% CI, 1.41-1.78]). This is the first lar ge-scale, prospective study to evaluate patient and process of care factors that influence pain control during FOE. It demonstrated that there are pat ient characteristics and process of care factors that need to be considered when evaluating pain during bronchoscopy. Improved preparation of patients with lower education, inferior health status, and asthma may lead to decre ased pain during FOE. Bronchoscopists may be able to reduce pain during FOE by identifying methods to decrease pain on scope insertion, by improving t he information provided to patients, and by achieving greater levels of amn esia during FOE.