Randomized double-blind study of dexmedetomidine and midazolamfor electronic bronchoscopy

Objective To compare the clinical value of dexmedetomidine combined with fentanyl wersus midazolam combined with fentanyl for sedation in electronic bronchoscopy. Methods This randomized double-blind prospective study was conducted on a total of 52 patients aged 18-70 in American Society of Anesthesiologists(ASA) grade 1-3 scheduled for elective electronic bronchoscopy who were randomly allocated into two groups: Group D (n=26) received dexmedetomidine combined with fentanyl and Group M (n=26) received midazolam combined with fentanyl.General data of patients; Mean arterial pressure(MAP), heart rate(HR) and oxygensaturation (SpO2) at six time points (T0, baseline; T1, passage of the bronchoscope through nasal cavity; T2, passage of the bronchoscope through vocal cords; T3, 1 min after T1; T4, 3 min after T1; T5, 5 min after T1); satisfaction scores of patients, examination matters, examination time and recovery time were recorded. Results HR in Group D was significantly lower than in Group M(P<0.05) at T1、T2、T3、T4、T5 while SpO2 was exactly the reverse.There were no significant differences between groups at T0 in terms of HR and SpO2.The cases of fentanyl requirements and hypoxemia occurrence in Group D were significantly less than in Group M (P<0.05) while the satisfactionrate was exactly the reverse.There were no significant differences between groups in cases of atropine or epinephrine syringe and in duration of examination and recovery. Conclusions Compared to midazolam, dexmedetomidine combined with fentanyl could be associated with less desaturation and higher patients satisfaction in patients detected by the electronic bronchoscopy.However, the examination and recovery time could be similar. Key words: Dexmedetomidine; Midazolam; Conscious Sedation; Bronchoscopy; Oximetry; Hemodynamics