Propofol versus dexmedetomidine as a sole sedative for diagnostic flexible bronchoscopy : a randomized double-blind study

الملخص EN

Context Sedation is commonly used to improve patients’ tolerance and comfort during fl exible bronchoscopy (FB).

Dexmedetomidine is a relatively novel sedative for use in FB.

Aims The aim of this study was to compare dexmedetomidine and propofol as sole sedative agent in terms of hemodynamics, effi cacy, safety and tolerance to the procedure among patients undergoing FB.

Settings and design This study was carried out in a tertiary care teaching hospital, and was a double-blind randomized-controlled trial.

Patients and methods Sixty patients were analyzed.

Group 1 received propofol (1 mg/kg bolus, then 5 mg/kg/h infusion); group 2 received dexmedetomidine (1 μg/kg bolus, followed by 0.7 μg/kg/h infusion).

Intraoperative (IOP) SpO2, heart rate, mean arterial pressure, and respiratory rate were recorded at nine time points.

Primary outcome variables were hemodynamic variables, level of sedation, and recovery time (to reach an Aldrete score 10/10).

Results The dexmedetomidine group showed signifi cantly lower mean heart rate than the propofol group at IOP0, IOP2, and IOP4.

The mean arterial pressure was signifi cantly higher throughout the procedure in the dexmedetomidine group compared with the propofol group (P < 0.001).

A signifi cant decrease in respiratory rate was noted in the dexmedetomidine group at IOP4 and IOP6 (P < 0.001).

The lowest mean SpO2 was noted in the dexmedetomidine group (97.0 ± 1.1).

Incidences of bucking and coughing were signifi cantly higher in the dexmedetomidine group.

Bronchoscopist visual analogue scale scores for coughing and satisfaction were signifi cantly lower in the propofol group (P < 0.001).

Recovery time was shorter in the propofol group [3 (1.2) vs.

4.5 (1.1) min] (P < 0.001).

Conclusion Propofol showed superiority over dexmedetomidine in terms of safety, effi cacy, adverse-effect profi le, and tolerance to the procedure in patients undergoing diagnostic fl exible bronchoscopy.