Effect of dexmedetomidine and midazolam for flexible fiberoptic bronchoscopy in intensive care unit patients

Park³

2019

Preprint

Background: There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy. The aim of this study was to evaluate the clinical efficacy and safety of remifentanil by comparing it with those of the conventional drugs, midazolam and propofol. Methods: A retrospective study of 186 patients who underwent diagnostic bronchoscopy at Chonbuk National University Hospital was performed. Patients were classified into the remifentanil group and midazolam/propofol group according to the drugs used during bronchoscopy. Results: Of the 186 patients, 111 patients received remifentanil and 75 received midazolam/propofol during the bronchoscopy. The proportion of patients who required bronchoscopy for endobronchial inspection alone was significantly higher in the midazolam/propofol group than in the remifentanil group (93.3% vs. 71.2%; p < 0.001). In contrast, the proportion of patients who required more invasive procedures, such as bronchoscopic biopsy, bronchoalveolar lavage, or transbronchial lung biopsy, was significantly higher in the remifentanil group than in the midazolam/propofol group (27.8% vs. 6.7%; p < 0.001). The recovery time was significantly shorter in the remifentanil group than in the midazolam/propofol group (mean 6.4 min vs. 11.6 min, p < 0.001). There was no significant difference between the groups with regard to safety events including desaturation, hypotension, and arrhythmia. Conclusions: Despite the higher proportion of patients who underwent more invasive procedures in the remifentanil group than in the midazolam/propofol group, there was no significant difference in safety events between the groups. Those in the remifentanil group also demonstrated a faster recovery time than those in the midazolam/propofol group.

Section: Discussionmentioning

confidence: 99%

Analgosedation during flexible fiberoptic bronchoscopy: Comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol

Park³

2019

Preprint

“…Although the current guidelines recommend the combined use of an opioid and midazolam for bronchoscopy sedation [3], physicians often use a single drug, or a combination of benzodiazepines, propofol, and opioids in this setting [5,6]. In addition, with the development of new drugs, remifentanil and dexmedetomidine have been introduced as options for analgosedation for flexible bronchoscopy in adults [7][8][9][10][11]. Accordingly, the combination of new drugs and conventional drugs has enabled a wide variety of combinations of drugs to be used for analgosedation for flexible bronchoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, the combination of new drugs and conventional drugs has enabled a wide variety of combinations of drugs to be used for analgosedation for flexible bronchoscopy. Several studies have demonstrated the safety and efficacy of the addition of remifentanil or dexmedetomidine (to conventional drugs) in adult patients who underwent flexible bronchoscopy [7][8][9][10]. However, the best-standardized practice for the use of sedation during bronchoscopy has yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

Analgosedation during flexible fiberoptic bronchoscopy: Comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol

Park³

2019

Preprint

Background: There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy. The aim of this study was to evaluate the clinical efficacy and safety of remifentanil by comparing it with those of conventional drugs, midazolam and propofol. Methods: A retrospective study of 186 patients who underwent diagnostic bronchoscopy at Chonbuk National University Hospital was performed. Patients were classified into the remifentanil group and midazolam/propofol group according to the drugs used during bronchoscopy. Results: Of the 186 patients, 111 patients received remifentanil and 75 received midazolam/propofol during the bronchoscopy. The proportion of patients who required bronchoscopy for endobronchial inspection alone was significantly higher in the midazolam/propofol group than in the remifentanil group (93.3% vs. 71.2%; p < 0.001). In contrast, the proportion of patients who required more invasive procedures, such as bronchoscopic biopsy, bronchoalveolar lavage, or transbronchial lung biopsy, was significantly higher in the remifentanil group than in the midazolam/propofol group (27.8% vs. 6.7%; p < 0.001). The recovery time was significantly shorter in the remifentanil group than in the midazolam/propofol group (mean 6.4 min vs. 11.6 min, p < 0.001). There was no significant difference between the groups with regard to safety events including desaturation, hypotension, and arrhythmia. Conclusions: Despite the higher proportion of patients who underwent more invasive procedures in the remifentanil group than in the midazolam/propofol group, there was no significant difference in safety events between the groups. Those in the remifentanil group also demonstrated a faster recovery time than those in the midazolam/propofol group.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analgosedation during flexible fiberoptic bronchoscopy: Comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol

Park³

2019

Preprint

Background: There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy. Methods: A retrospective study of 186 patients who underwent diagnostic bronchoscopy at Chonbuk National University Hospital was performed. Patients were classified into the remifentanil group and midazolam/propofol group according to the drugs used during bronchoscopy. The aim of this study was to evaluate the clinical efficacy and safety of remifentanil by comparing it with those of conventional drugs, midazolam and propofol. Results: Of the 186 patients, 111 patients received remifentanil and 75 received midazolam/propofol during the bronchoscopy. The proportion of patients who required bronchoscopy for endobronchial inspection alone was significantly higher in the midazolam/propofol group than in the remifentanil group (93.3% vs. 71.2%; p < 0.001). In contrast, the proportion of patients who required more invasive procedures, such as bronchoscopic biopsy, bronchoalveolar lavage, or transbronchial lung biopsy, was significantly higher in the remifentanil group than in the midazolam/propofol group (27.8% vs. 6.7%; p < 0.001). The recovery time was significantly shorter in the remifentanil group than in the midazolam/propofol group (mean 6.4 min vs. 11.6 min, p < 0.001). There was no significant difference between the groups with regard to safety events including desaturation, hypotension, and arrhythmia. Conclusions: Despite the higher proportion of patients who underwent more invasive procedures in the remifentanil group than in the midazolam/propofol group, there was no significant difference in safety events between the groups. Those in the remifentanil group also demonstrated a faster recovery time than those in the midazolam/propofol group.