Abstract: Objective To compare the effect of three different anesthesia methods on bronchoscopy in patients with tuberculosis. Method 90 painless bronchoscopy cases admitted to the Third People's Hospital of Shenzhen from December 2021 to March 2022 were selected, and were randomly divided into three groups with 30 cases in each group: local anesthesia group (group C), midazolam combined with remifentanil group (group M), midazolam combined with meperidine combined with cricothyroid membrane puncture group (group T). BP, HR, and SpO₂ were recorded before anesthesia (T0), after anesthesia induction (T1), bronchoscope inserted into the glottis (T2), and during operation (T3). The recovery time, steward recovery score, and the incidence of adverse reactions were recorded. And the patient's satisfaction, the anesthetic effect were observed. Result Compared with T0, MBP and HR at T2 and T3 time points in group C were significantly increased;BP and HR at T1 time point in group M were significantly decreased (P<0.05);There was no significant difference in group T. Compared with group C, BP and HR at T1, T2 and T3 time points were lower in group M, MBP and HR at T2 and T3 time points were lower in group T (P<0.05). In group C, the incidence of adverse reactions was higher, the anesthesia excellence rate was lower, and the patients’ satisfaction was decreased (P<0.05). The recovery time was significantly shortened in group T, and the recovery score, anesthesia effect were significantly increased (P<0.05). Oxygen protection below 90% in 5 patients in group M only. Conclusion Midazolam compound pethidine combined with Cricothyroid membrane puncture is used for painless bronchoscopy in tuberculosis patients, which can effectively reduce the incidence of adverse reactions such as respiratory depression and cough, and the hemodynamics is more stable.

Key words: Bronchoscopy, Pulmonary tuberculosis, Anesthesia, Cricothyroid membrane puncture