Abstract
BackgroundThere 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.MethodsA 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.ResultsOf 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. 73.0%; 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 (27.0% 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 were no significant differences between the groups with regard to safety events including desaturation, hypotension, and arrhythmia.ConclusionsDespite 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.
Highlights
There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy
The patients were stratified into the remifentanil group and midazolam/propofol group according to the drugs used during flexible bronchoscopy
The midazolam/propofol group received a median of 2 mg of midazolam (IQR, 0–4 mg) and 50.2 μg/kg/min (39.0–64.3 μg/kg/min) of propofol
Summary
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. 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]. 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]. The best-standardized practice for the use of sedation during bronchoscopy has yet to be determined
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
