Chest
Clinical Investigations: Bronchos-Copy/LavageA Comparative Evaluation of Propofol and Midazolam as Sedative Agents in Fiberoptic Bronchoscopy
Section snippets
Patients
Forty-one consecutive patients with known bronchial asthma (American Thoracic Society criteria) undergoing elective fiberoptic bronchoscopy were randomly allocated to receive either intravenous midazolam or propofol as a sedative agent. Indications for bronchoscopy included persistent cough, hemoptysis, or suspected bronchogenic neoplasm. Informed consent was obtained from each patient and the study was approved by the James Connolly Memorial Hospital Ethics Committee. All patients were
Results
Forty-one patients were studied, of whom 20 received midazolam and 21 received propofol. There were no significant differences between the propofol and midazolam groups in terms of age, weight, indications for bronchoscopy, baseline FEV1 values, or ASA physical status (Table 1). Bronchoscopic procedures carried out were similar in both groups, including bronchoalveolar lavage in six patients in both groups and endobronchial biopsies in four and three patients in the midazolam and propofol
Discussion
To our knowledge, there are no data available on propofol as a sedating agent in day-case fiberoptic bronchoscopy. At present, midazolam is the most commonly used sedative agent in this procedure, because it has a documented rapid onset and short duration of action in normal subjects. However, side effects of midazolam include a significant variation in individual dose requirements and respiratory depression. In about 6 percent of the population, it has a delayed metabolism leading to
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2018, Clinics in Chest MedicineCitation Excerpt :Studies have found improved patient perception of sedation, anxiolysis, and procedure tolerance and overall reduction in cough and the sensation of asphyxiation when propofol is administered.34 Propofol is becoming increasingly more common in the bronchoscopy suite, as it has amnestic properties, with a quicker onset and faster recovery time than other agents, such as midazolam.35–38 Propofol can be administered as bolus or a continuous drip, with a similar side effect profile, but one randomized trial found higher doses and longer procedure time associated with infusion therapy.39
Sedation with Propofol and Propofol.Ketamine (Ketofol) in Flexible Bronchoscopy: A Randomized, Double.Blind, Prospective Study
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