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Sedation for bronchofiberoscopy: comparison between propofol infusion and intravenous boluses of fentanyl and diazepam
Author(s) -
Randell T.
Publication year - 1992
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1992.tb03453.x
Subject(s) - medicine , propofol , anesthesia , fentanyl , sedation , diazepam , lidocaine , midazolam , bolus (digestion) , surgery
Two methods of sedation were evaluated in unpremedicated patients undergoing elective bronchofiberoscopy. The patients were randomly allocated to receive either propofol infusion 1 mg kg ‐1 h ‐1 preceded by a 1 mg kg ‐1 bolus (15 patients) (the propofol group) or intravenous fentanyl 1 μg kg ‐1 and diazepam 0.05 mg kg ‐1 (15 patients) (the fentanyl + diazepam group). Thirteen patients were treated twice during the study period and sedated with both methods (the first treatment according to random order and the second with the method not used on the first occasion). A topical anaesthetic was applied to the selected nostril with two cotton swabs soaked in 4% lidocaine. Epiglottis, vocal cords, trachea and bronchi were anaesthetized by spraying 4% lidocaine through the working channel of the fiberoscope as the instrument was advanced. The patients in the propofol group were more sedated than those in the fentanyl + diazepam group ( P <0.01). The working conditions were the same. After sedation, respiratory frequency decreased only in the fentanyl + diazepam group ( P <0.05). Before sedation, haemoglobin saturation of oxygen was 95 ± 2% (mean ± s.d.) in the propofol group and 94 ± 3% in the fentanyl + diazepam group. Immediately before the start of bronchofiberoscopy, it was 89 ± 4% and 90 ± 3%, respectively. The decrease was statistically significant in both groups ( P <0.001). After sedation, systolic arterial pressures (SAP) decreased in both groups ( P <0.01). Compared to values immediately before starting bronchofiberoscopy, SAP increased during the procedure in both groups ( P <0.05). A significant increase ( P <0.05) in heart rate was noted in both groups. The patients recovered in 30 min after the end of bronchofiberoscopy. There were no significant differences in recovery between the groups.