Sedation for fiberoptic bronchoscopy: review of the literature

Talay, Fahrettin; Kargi, Ahmet; Yaşar, Zeki; Tuğ, Tuncer

doi:10.5578/tt.8849

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…[3] In short, the influence of this technique in ICU patients can ultimately lead to worse respiratory cycle. [11] FFB is more invasive and painful than other techniques; sedation can reduce patient anxiety and pain, and enhance comfort, thus reducing further serious injury.…”

Section: Discussionmentioning

confidence: 99%

“…Although FFB is predominantly used for the diagnosis and treatment of respiratory diseases in critically ill patients, [1,2] the invasive nature of this technology can induce cough, dyspnea, airway reflex contraction, laryngospasm, and catecholamine release, with further detrimental effects on patient prognosis. [3] Consequently, the American College of Chest Physicians has highlighted the necessity of using sedation combined with topical anesthesia during FFB. [4] Appropriate sedation and analgesia during this procedure can improve patient tolerance and comfort, reduce fear, anxiety, and mental stress, and improve overall clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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This study aimed to investigate the clinical effectiveness of dexmedetomidine and midazolam for sedation of intensive care unit (ICU) patients requiring flexible fiberoptic bronchoscopy (FFB).This retrospective cohort study included 148 patients from the third ICU ward of the Second Affiliated Hospital of Harbin Medical University (Harbin, China) who received simultaneous invasive mechanical ventilation and FFB between March 2012 and December 2014. Patients were divided into dexmedetomidine (n = 72) and midazolam (n = 76) groups according to sedative mode. The sedative effects, incidence of adverse events, and bronchoscopist satisfaction scores were compared between groups.During FFB, total sedation time and total time of FFB were significantly shorter in the midazolam group (P < .001, respectively), with a lower percentage of these patients requiring propofol for remedial sedation (P < .001). The incidence of FFB-related adverse events (including bronchospasm, cough, and decreased oxygen saturation) was significantly higher in dexmedetomidine group compared with midazolam group (P = .007, .014 and .008, respectively). However, the incidence of other adverse events was not significantly different between groups. In addition, bronchoscopist satisfaction scores were significantly higher in the midazolam compared with dexmedetomidine group (7.72 ± 1.65 vs 7.08 ± 1.77; P = .030).For sedation of ICU patients during FFB, combination of midazolam and dexmedetomidine demonstrated an enhanced sedative effect, lower incidence of adverse events, and higher bronchoscopist satisfaction score compared with dexmedetomidine alone, thus represents a suitable alternative sedative for FFB patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…Coughing is one of the most distressing symptoms during FB, potentially leading to significant changes in haemodynamics and an increased risk of post-lung biopsy pneumothorax [ 31 , 32 ]. Despite our patients in the SN group exhibiting a significantly lower cough rate than those in the CS group, we observed only one instance of oxygen desaturation among our study participants, with no discernible differences in adverse events between the groups.…”

Section: Discussionmentioning

confidence: 99%

Spray nozzle for topical anaesthesia during flexible bronchoscopy: a randomised controlled trial

Huang,

Chou,

Chang

et al. 2024

ERJ Open Res

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BackgroundEffectiveness of using a spray nozzle to deliver lidocaine for superior topical airway anaesthesia during non-sedation flexible bronchoscopy(FB) remains a topic of uncertainty when compared to conventional methods.MethodsPatients referred for FB were randomly assigned to receive topical lidocaine anaesthesiaviathe bronchoscope's working channel(Classical Spray, CS group) or through a washing pipe equipped with a spray nozzle(SN group). The primary outcome was the cough rate, defined as the total number of coughs per minute. Secondary outcomes included subjective perceptions of both the patient and operator regarding the FB process. These perceptions were rated on a visual analogue scale (VAS), with numerical ratings ranging from 0 to 10.ResultsOur study enrolled a total of 126(61 CS group; 65 SN group) patients. The SN group exhibited a significantly lower median cough rate compared to the CS group(4.5versus7.1 per minute; p=0.021). Patients in the SN group also reported less oropharyngeal discomfort(4.5±2.7versus5.6±2.9; p=0.039), better tolerance of the procedure(6.8±2.2versus5.7±2.7; p=0.011), and a greater willingness to undergo a repeat FB procedure(7.2±2.7versus5.8±3.4; p=0.015) compared to those in the CS group. From an operator's perspective, patient discomfort(2.7±1.7versus3.4±2.3; p=0.040) and cough scores(2.3±1.5versus3.2±2.4; p=0.013) were lower in the SN group compared to the CS group, with less disruption due to coughing observed among SN patients(1.6±1.4versus2.3±2.3; p=0.029).ConclusionsThis study illustrates that employing a spray nozzle for the delivery of lidocaine provides superior topical airway anaesthesia during non-sedation FB, compared to the traditional method.

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The utility of a multi-orifice epidural catheter when using the “Spray-as-You-Go” technique for topical Airway Anesthesia during Flexible Bronchoscopy, a randomised trial

Cai

Chen

Dong

et al. 2022

J Clin Monit Comput

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Sedation for fiberoptic bronchoscopy: review of the literature

Cited by 6 publications

References 26 publications

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

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

Spray nozzle for topical anaesthesia during flexible bronchoscopy: a randomised controlled trial

The utility of a multi-orifice epidural catheter when using the “Spray-as-You-Go” technique for topical Airway Anesthesia during Flexible Bronchoscopy, a randomised trial

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