ORIGINAL ARTICLE
Year : 2015  |  Volume : 8  |  Issue : 4  |  Page : 573-579

Propofol versus dexmedetomidine as a sole sedative for diagnostic flexible bronchoscopy: a randomized double-blind study


1 Department of Anesthesiology and Critical Care, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of Pulmonary Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India

Correspondence Address:
Mohd Saif Khan
No. 3-A, D Block, PIMS Staff Quarters, P.I.M.S. Hospital, Kalapet, Puducherry 605014
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-7934.172743

Clinical trial registration CTRI:REF/2013/10/005804

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Context Sedation is commonly used to improve patients' tolerance and comfort during flexible bronchoscopy (FB). Dexmedetomidine is a relatively novel sedative for use in FB. Aims The aim of this study was to compare dexmedetomidine and propofol as sole sedative agent in terms of hemodynamics, efficacy, safety and tolerance to the procedure among patients undergoing FB. Settings and design This study was carried out in a tertiary care teaching hospital, and was a double-blind randomized-controlled trial. Patients and methods Sixty patients were analyzed. Group 1 received propofol (1 mg/kg bolus, then 5 mg/kg/h infusion); group 2 received dexmedetomidine (1 mg/kg bolus, followed by 0.7 mg/kg/h infusion). Intraoperative (IOP) SpO 2 , heart rate, mean arterial pressure, and respiratory rate were recorded at nine time points. Primary outcome variables were hemodynamic variables, level of sedation, and recovery time (to reach an Aldrete score 10/10). Results The dexmedetomidine group showed significantly lower mean heart rate than the propofol group at IOP 0 , IOP 2 , and IOP 4 . The mean arterial pressure was significantly higher throughout the procedure in the dexmedetomidine group compared with the propofol group (P < 0.001). A significant decrease in respiratory rate was noted in the dexmedetomidine group at IOP 4 and IOP 6 (P < 0.001). The lowest mean SpO 2 was noted in the dexmedetomidine group (97.0 ± 1.1). Incidences of bucking and coughing were significantly higher in the dexmedetomidine group. Bronchoscopist visual analogue scale scores for coughing and satisfaction were significantly lower in the propofol group (P < 0.001). Recovery time was shorter in the propofol group [3 (1.2) vs. 4.5 (1.1) min] (P < 0.001). Conclusion Propofol showed superiority over dexmedetomidine in terms of safety, efficacy, adverse-effect profile, and tolerance to the procedure in patients undergoing diagnostic flexible bronchoscopy.


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