The effect of midazolam premedication on patient satisfaction during fiberoptic bronchoscopy under patient-controlled sedation.
- Author:
Won Kyoung KWON
1
;
Eun Su CHOI
;
Ji Young KIM
;
Sang Ri PARK
;
Hyo Seok NA
;
Sang Hyun PARK
;
Hee Pyoung PARK
;
Young Tae JEON
;
Jung Won HWANG
Author Information
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords: Alfentanil; Bronchoscopy; Midazolam; Patient-controlled sedation; Propofol
- MeSH: Alfentanil; Amnesia; Blood Pressure; Bronchoscopes; Bronchoscopy; Heart Rate; Humans; Midazolam; Patient Satisfaction; Premedication; Propofol; Vital Signs
- From:Korean Journal of Anesthesiology 2009;56(1):1-5
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: Patient-controlled sedation (PCS) with propofol is a safe and effective method of attenuating discomfort during fiberoptic bronchoscopy. The purpose was to evaluate the usefulness of midazolam in addition to PCS for fiberoptic bronchoscopy. METHODS: We randomly assigned 155 patients undergoing diagnostic bronchoscopy to two groups. Group M (n = 79) received 0.03 mg/kg of midazolam for premedication while group P (n = 76) received a loading dose (0.05 ml/kg) of PCS solution composed of 200 mg (20 ml) of propofol and 1 mg (2 ml) of alfentanil. Both groups received the PCS solution 0.2 ml/kg/hr with a bolus of 1 ml and a lockout time of 1 min. Vital signs, pulmonologist satisfaction, patient satisfaction and amnesia were evaluated. RESULTS: After the insertion of the bronchoscope, there was a slight decrease of SpO2 and an increase of blood pressure and heart rate in both groups with no significant differences between the two groups. The group P required more bolus injections (1.6 +/- 1.7 in the group M vs 2.5 +/- 2.2 in group P; P < 0.05). There was no difference in the satisfaction of pulmonologists, but the satisfaction of patients was higher in the group M (P < 0.05). More patients in the group P (93%) remembered the procedure than in the group M (70%) (P < 0.05). CONCLUSIONS: PCS is an effective method for sedating patients undergoing fiberoptic bronchoscopy and midazolam provides more patient satisfaction and amnesia.
