Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial
Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial
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DOI：
10.1183/09031936.00180808
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发表时间：
2009-11-01
影响因子：
24.3
通讯作者：
Tamm, M.
中科院分区：
文献类型：
--
作者：
Stolz, D.;Kurer, G.;Tamm, M.
建议将苯二氮卓类和阿片类药物联合镇静作为支气管镜检查的标准镇静。异丙酚是一种镇静催眠药，起效快，恢复快，但存在呼吸衰竭的潜在风险。200例患者随机分为咪达唑仑和氢可酮联合用药组和丙泊酚静注组。主要终点是支气管镜检查期间的平均最低动脉血氧饱和度和手术后1小时的出院准备评分。支气管镜检查期间的平均最低动脉血氧饱和度在不同治疗组之间没有差异(p=0.422)，检查后1小时记录的动脉血氧饱和度的患者数量没有差异。71例(35.5%)患者出现了轻微的手术并发症，两个治疗组的发生率相似(p=0.460)。异丙酚在接受柔性支气管镜检查的患者中与复合镇静剂一样有效和安全，因此如果需要及时出院，这是一个有吸引力的选择。
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 = 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.