Application of bispectral index monitoring in sedation and analgesia for flexible bronchoscopy

Abstract

Objective: To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy. Methods: Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years). The 2 groups were compared in terms of operation time, blood pressure, heart rate and other indicators during bronchoscopy including incidence of adverse events, memory of the procedure, willingness to be re-examined, safety of sedation and analgesia for bronchoscopy under bispectral index monitoring, and patient satisfaction in the postoperative follow-up. Results: The conscious sedation group and the control group had no difference in age and sex ratio(P>0.05). Compared with the patients in the control group(operation time 16±5 min and systolic blood pressure 153±21 mmHg, 1 mmHg=0.133 kPa), those in the conscious sedation group had a shorter operation time(14±5 min) and a lower systolic blood pressure(144±22 mmHg), with statistically significant difference (P<0.01). There was no significant difference in diastolic blood pressure and heart rate (89±14 mmHg and 84±17 times/min in the conscious sedation group and 92±12 mmHg and 87±14 times/min in the control group, P>0.05). Adverse events, overall intraoperative cough and bleeding were found to be significantly reduced in the conscious sedation group (27%, 4% and 13% and 60%, 13% and 35% in the control group, P<0.01), but transient hypoxia was not (12% in the conscious sedation group, and 14% in the control group, P=0.72). Patient satisfaction and willingness to be re-examined were markedly higher in the conscious sedation group (97%) than in the controls (4%, P<0.01). Conclusions: Bispectral index monitoring is safe in sedation and analgesia for bronchoscopy and has higher patient satisfaction, suggesting that it is a potential tool for use in clinical practice.