Document Detail


Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial.
MedLine Citation:
PMID:  19386684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Combined sedation with a benzodiazepine and an opiate has been proposed as standard sedation for bronchoscopy. Propofol is a sedative-hypnotic with a rapid onset of action and fast recovery time, but carries the potential risk of respiratory failure. Consecutive patients (n = 200) were randomly allocated to receive either the combination midazolam and hydrocodone or intravenous propofol. The primary end-points were the mean lowest arterial oxygen saturation during bronchoscopy and the readiness-for-discharge score 1 h after the procedure. The mean lowest arterial oxygen saturation during bronchoscopy did not differ across treatment groups (p = 0.422), and the number of patients recording an arterial oxygen saturation of < or =90% on at least one occasion was similar in both groups (p = 0.273). The median (interquartile range) readiness-for-discharge score 1 h after the procedure was significantly higher in the propofol group than in the combined sedation group (8 (6-9) versus 7 (5-9); p = 0.035). Patients assigned propofol exhibited less tachycardia during bronchoscopy and for > or =1 h after the examination. Minor procedural complications were noted in 71 (35.5%) patients and exhibited a similar incidence in both treatment arms (p = 0.460). Propofol is as effective and safe as combined sedation in patients undergoing flexible bronchoscopy, thus representing an appealing option if timely discharge is a priority.
Authors:
D Stolz; G Kurer; A Meyer; P N Chhajed; E Pflimlin; W Strobel; M Tamm
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-04-22
Journal Detail:
Title:  The European respiratory journal     Volume:  34     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-03-16     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  1024-30     Citation Subset:  IM    
Affiliation:
Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. dstolz@uhbs.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anesthetics, Intravenous / administration & dosage,  therapeutic use
Bronchoscopy / methods*
Female
Humans
Hydrocodone / administration & dosage
Infusions, Intravenous
Male
Midazolam / administration & dosage
Middle Aged
Oxygen / metabolism
Propofol / administration & dosage,  therapeutic use*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 125-29-1/Hydrocodone; 2078-54-8/Propofol; 59467-70-8/Midazolam; 7782-44-7/Oxygen

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