Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: A randomized study

Yuan, Feng; Fu, Hongguang; Yang, Pengju; Sun, Kai; Wu, Shubiao; Lv, Miaomiao; Dong, Zhenzhen; Dong, Tieli

doi:10.3892/etm.2016.3274

Cited by 31 publications

(40 citation statements)

References 44 publications

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“…A convenience sample size of fifty patients in each group was chosen based on the inflow of patients at our centre. Our study was similar to studies by Grendelmeier et al who investigated the safety of sedation with propofol in flexible bronchoscopy 13 in a large group and another smaller randomised study by Feng Yuan et al 14 Values presented with in ( ) as percentage %.…”

Section: Methodssupporting

confidence: 87%

Total Intravenous Anaesthesia Using Propofol and Ketamine Combination Versus Propofol and Fentanyl Combination in Patients Undergoing Bronchoalveolar Lavage

Krishnamurthy¹,

Sudhakar²

2018

jemds

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BACKGROUND Flexible bronchoscopy being an invasive procedure can induce cough, pain etc., thus requiring deep sedation or anaesthesia to offset these adverse effects. Aim-To compare the combination of Propofol with Ketamine (Group PK) versus combination of Propofol with Fentanyl (Group PF) for total intravenous anaesthesia (TIVA) in 100 patients. MATERIALS AND METHODS 100 patients undergoing flexible bronchoscopy for bronchoalveolar lavage were divided into two groups-Group PK where 50 patients received propofol 2.0 mg/kg and ketamine 1.0 milligram/kg IV and Group PF where 50 patients received propofol 2.0 mg/kg and Fentanyl 1.0 microgram/kg IV in a double-blind study. The parameters measured between the groups included haemodynamics, maintenance of oxygen saturation, cough, sedation levels, need for rescue doses, recovery time as well as pulmonologist and patient satisfaction. RESULTS Almost all the measured parameters between Group PK and Group PF were similar and statistically insignificant. The only statistically significant difference was found in recovery time being longer in Group PK at 14.1 ± 0.32 mins compared to Group PF at 10.3 ± 1.64 mins. CONCLUSION We can hereby conclude that Total Intravenous Anaesthesia (TIVA) using Propofol (2 mg/kg) and Ketamine (1 mg/kg) combination versus Propofol (2 mg/kg) and Fentanyl (1 microgm/kg) combination for flexible bronchoscopy in patients undergoing bronchoalveolar lavage are similar in terms of all parameters measured, except a longer duration of recovery time for propofol-ketamine group.

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Section: Methodssupporting

confidence: 87%

Total Intravenous Anaesthesia Using Propofol and Ketamine Combination Versus Propofol and Fentanyl Combination in Patients Undergoing Bronchoalveolar Lavage

Krishnamurthy¹,

Sudhakar²

2018

jemds

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“…Some studies suggest that fentanyl could cause mild respiratory depression. [13,14] However, a randomized study comparing the midazolam group and fentanyl-midazolam groups found no significant difference in blood SpO2 during bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Zhang

Zhou

Xiong

et al. 2020

Preprint

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Background: Sedation combined with local anesthesia during bronchoscopy is widely accepted in America and Europe, and receiving great attention in China. This study aimed to investigate the safety and efficacy of fentanyl combined with midazolam for bispectral index (BIS) titrated conscious sedation during bronchoscopy in the Chinese population. Methods: Data from 436 patients who underwent bronchoscopy under local anesthesia (LA group) or BIS-guided conscious sedation combined with local anesthesia (FM group) were retrospectively analyzed. The analysis included vital signs, adverse events recorded during the procedure, and questionnaire information, such as patient tolerance and satisfaction, operator satisfaction, and the cough score noted after the procedure. Results: A total of 225 patients in the LA group, and 211 in the FM group were enrolled in the study. The blood pressure and oxygen saturation were significantly higher in the LA group than in the FM group during bronchoscopy (P<0.001). The heart rate was significantly faster in the LA group at T3max, T3min and T4 than in the FM group. The incidence of hypoxia and bradycardia was higher in the FM group than in the LA group, whereas incidence of hypertension and tachycardia was lower. Patient satisfaction and tolerance of the procedure were significantly better in the FM group. visual analog scale (VAS) scores for cough and operator satisfaction were better in the FM group than in the LA group. Sub-group analysis (inspection, biopsy and transbronchial biopsy guided by radial endobronchial ultrasound (rEBUS-TBB)) indicated that the vital signs, adverse event(hypoxia) and patient satisfaction of the two groups were similar to the previous results. However, the VAS scores for operators’ satisfaction was no significant difference between the two groups in patients undergoing inspection. Conclusions: The conscious sedation regimen of fentanyl combined with midazolam monitored by BIS during bronchoscopy is safe and effective. Although the incidence of hypoxia and bradycardia was higher, the patient’s tolerance and physician’s satisfaction were significantly improved, especially during lengthy procedures, such as intrabronchial biopsy and transbronchial biopsy guided by radial endobronchial ultrasound. Trial registration: The study was approved by the ethics committee of Changzhou first people's Hospital (2019-020). Key words: bronchoscopy, bispectral index, conscious sedation, midazolam, fentanyl.

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“…Dexmedetomidine is used in the clinic for analgesia, sedation and reduction of anesthetic agents. Reasonable application of anesthetics may reduce the occurrence of post-operative complications and rapidly exert anesthetic effects to achieve timely recovery and promote the improvement and recovery of spinal cord injury (21). Although dexmedetomidine is not recommended for pregnant females, a previous study indicated that appropriate doses of dexmedetomidine are beneficial for sedation of pregnant subjects (22).…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine combined with lumbar anesthesia on Th1/Th2 in maternal patients and neonates undergoing caesarean section

Shi

Zhang

2019

Exp Ther Med

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The selection of anesthetic method and drugs is of utmost importance for patients undergoing caesarean section. The application of anesthetic drugs may affect the immune system of the maternal patient and neonate. Therefore, the present study aimed to analyze the effect of dexmedetomidine combined with lumbar anesthesia on type 1 T-helper cells (Th1) and Th2 cytokines in mothers and their neonates undergoing caesarean section. A total of 60 females with full-term pregnancies and an American Society of Anesthesiologists grade I or II who received caesarean section were selected and equally divided in a randomized manner into a control group receiving lumbar epidural anesthesia and a combination group treated by dexmedetomidine combined with lumbar epidural anesthesia. The visual analogue scale (VAS) score, adverse reactions, traction response and the neonates' Apgar score were compared between the two groups. The levels of interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α), IL-4 and IL-10 in the blood of mothers and neonates were detected by reverse transcription-quantitative PCR and ELISA. The results indicated no statistically significant difference in the Apgar score between the two groups. The VAS scores, adverse reactions, reduced traction response, as well as IL-2 and TNF-α expression, in the mothers of the combination group were significantly decreased, while IL-4 and IL-10 were obviously elevated compared with those in the controls (P<0.05). Furthermore, IL-2 and TNF-α levels were markedly declined, whereas IL-4 and IL-10 expression was apparently enhanced in the neonates from the combination group compared with those in the control group (P<0.05). In conclusion, dexmedetomidine in addition to lumbar epidural anesthesia reduces the VAS score, adverse reactions and traction response, and promotes the conversion of Th1 cytokines to Th2 cytokines in mothers/nonates after caesarean section.

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Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: A randomized study

Cited by 31 publications

References 44 publications

Total Intravenous Anaesthesia Using Propofol and Ketamine Combination Versus Propofol and Fentanyl Combination in Patients Undergoing Bronchoalveolar Lavage

Total Intravenous Anaesthesia Using Propofol and Ketamine Combination Versus Propofol and Fentanyl Combination in Patients Undergoing Bronchoalveolar Lavage

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Effect of dexmedetomidine combined with lumbar anesthesia on Th1/Th2 in maternal patients and neonates undergoing caesarean section

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