Study objective: Bronchoscopic technique is not
standardized. Controversies exist with regard to premedication with
sedatives before the test. To evaluate safety and efficacy of conscious
sedation, we studied 100 randomized patients undergoing diagnostic
bronchoscopy; patients received premedication with lidocaine spray and
atropine sulfate IM (nonsedation group; 50 patients) or lidocaine
spray, atropine IM and diazepam IV (sedation group; 50 patients).
Methods and results: Monitoring during flexible fiberoptic
bronchoscopy included continuous ECG and pulse oximetry. The procedure
could not be completed in six patients. None received premedication
with diazepam; among the patients who ended the examination, tolerance
to the examination (visual analogue scale, 0 to 100; 0 = excellent;
100 = unbearable) was better in the sedation group. Low anxiety, male
sex, but not age were also associated with improved patient tolerance
to the test. Oxygen desaturation occurred in 17% of patients, and it
was not more frequent after diazepam treatment.
Conclusions: In our study, sedation had a beneficial effect
on patient tolerance and rarely induced significant alterations in
cardiorespiratory monitoring parameters.
FFB = flexible fiberoptic bronchoscopy; HR = heart rate;
Spo2 = oxygen saturation by pulse oxyimeter;
VAS = visual analogue scale