Fibreoptic bronchoscopy: is sedation necessary?

Pearce, Scott

doi:10.1136/bmj.281.6243.779

Cited by 48 publications

(10 citation statements)

References 3 publications

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“…F lexible fiberoptic bronchoscopy (FFB) is a stressful experience and thus sedation may be necessary to relieve anxiety and ease discomfort. While the need for sedation during bronchoscopy appears somewhat controversial (1–3), many anxious patients would not tolerate a bronchoscopic procedure without sedation (4, 5).…”

mentioning

confidence: 99%

Comparison of alfetanil and ketamine in combination with propofol for patient‐controlled sedation during fiberoptic bronchoscopy

Hwang

Jeon

Park

et al. 2005

Acta Anaesthesiol Scand

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confidence: 99%

Comparison of alfetanil and ketamine in combination with propofol for patient‐controlled sedation during fiberoptic bronchoscopy

Hwang

Jeon

Park

et al. 2005

Acta Anaesthesiol Scand

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“…Operators often tend to minimise patient discomfort [3][4][5] and, although FB can be performed without sedation [6][7][8], a recent survey revealed that 80% of patients prefer to be sedated during FB [4].…”

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confidence: 99%

Titrated sedation with propofol or midazolam for flexible bronchoscopy: a randomised trial

Clark¹,

Licker²,

Ab³

et al. 2009

European Respiratory Journal

122

116

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In this study, we questioned whether propofol provided clinical benefits compared with midazolam in terms of neuropsychometric recovery, safety profile and patient tolerance.Patients, aged .18 yrs, were randomised to receive midazolam or propofol, given by nonanaesthetist physicians to achieve moderate levels of sedation as assessed by the electroencephalographic bispectral index (BIS; between 70 and 85). The primary end-point was the time delay until recovery of the BIS above 90. Other end-points included a neuropsychometric continuous performance test (CPT), serious respiratory adverse events, patient tolerance and physician satisfaction.Neuropsychometric recovery was improved in the propofol compared to the midazolam group as evidenced by faster normalisation of BIS index (5.4¡4.7 min versus 11.7¡10.2 min; p50.001) and better results at the CPT. In the midazolam group, 15% of patients presented profound sedation precluding CPT completion and one patient required mechanical ventilatory support. Patient tolerance was significantly better in the propofol group, whereas the operator's assessment was comparable in both groups.Compared with midazolam, propofol provided a higher quality of sedation in terms of neuropsychometric recovery and patient tolerance. BIS-guided propofol administration represents a safe sedation technique that can be performed by the non-anaesthesiologist.

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“…The authors concluded that the use of sedation did not result in an increase in tolerability of the procedure (Table 1, Evidence Category B). 11 A short report on 100 patients receiving routine diagnostic bronchoscopies was published by Pearce 16 in 1980. All patients received atropine 0.6 mg, 2 benzocaine lozenges, and topical pharyngeal anesthesia with 4% lignocaine.…”

Section: Sedation Does Not Improve Outcomes Of Bronchoscopymentioning

confidence: 99%

Is Sedation Necessary for Successful Completion of Flexible Bronchoscopy?

Khan

Haponik

Chatterjee

et al. 2010

Clinical Pulmonary Medicine

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Flexible bronchoscopy is generally a safe procedure with few complications. The procedure is usually performed with sedation to maximize patient comfort. However, use of sedation may predispose the patient to cardiorespiratory complications. We carried out a literature review to evaluate the myth that sedation is required for successful completion of flexible bronchoscopy without causing undue distress to the patient and an increase in complications.

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Fibreoptic bronchoscopy: is sedation necessary?

Cited by 48 publications

References 3 publications

Comparison of alfetanil and ketamine in combination with propofol for patient‐controlled sedation during fiberoptic bronchoscopy

Comparison of alfetanil and ketamine in combination with propofol for patient‐controlled sedation during fiberoptic bronchoscopy

Titrated sedation with propofol or midazolam for flexible bronchoscopy: a randomised trial

Is Sedation Necessary for Successful Completion of Flexible Bronchoscopy?

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