Diagnostic bronchoscopy is an invasive procedure performed to diagnose respiratory diseases. But pain has been complained by most of the patients receiving such procedures. Sedation or anesthesia was required by both of the patients and bronchoscopists. Unfortunately, no consensus has been made upon the sedation strategies. Multiple sedation approaches have been applied, such as midazolam and fentanyl, remifentanil and propofol, dexmedetomidine and propofol. The present study was designed to compare these protocols in sedation for diagnostic bronchoscopy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
200
Midazolam is used as a common medication for sedation in all groups.
Fentanyl is another opioid drug used for analgesia to prevent bronchoscopy induced cough.
Dexmedetomidine is used for sedation in bronchoscopy with less impact on respiration.
Faculty of Anesthesiology, Changhai Hospital
Shanghai, Shanghai Municipality, China
Cough score
Cough score across the procedure will be classified into 4 degree (1-4) as follows. 1 = none, 2 = one gag or cough only, 3 = \>1 gag or cough, but acceptable conditions, 4 = unacceptable conditions
Time frame: From the completion of local anesthesia with lidocaine to the completion of bronchoscopy procedure, assessed up to 2 hours
Body movement
The numbers of the times of any body movement across the procedure
Time frame: From the completion of local anesthesia with lidocaine to the completion of bronchoscopy procedure, assessed up to 2 hours
Satisfaction score of the patients and bronchoscopists
Satisfaction score of the patients and bronchoscopists regarding to the sedation quality measured by a 0-100 visual analogue scale (VAS). 100 refers to the highest satisfaction degree while 0 refers to the worst satisfaction degree. The scale score was determined by the subjective determination of the satisfaction on the sedation quality.
Time frame: Across the procedure, assessed up to 2 hours
Amount of the rescue use of propofol
The total amount of propofol used as a rescue therapy when the sedation is not deep enough as assessed by the anesthesiologists.
Time frame: After sedation induction, assessed up to 2 hours
Recovery time
Duration of the recovery from sedation
Time frame: After termination of the sedation medication, assessed up to 2 hours
Prevalence of the side effects of respiratory and circulatory system
The number of the side effects in respiratory and circulatory system during the procedure, including hypertension, hypotension, tachycardia, bradycardia, hypoxia and larynx spasm.
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Remifentanil is used for analgesia to prevent bronchoscopy induced cough.
Propofol is used for sedation with high efficacy but more side effect on respiration than dexmedetomidine.
Time frame: Across the sedation duration, assessed up to 2 hours