Effects of remimazolam versus propofol sedation on pulmonary ventilation in patients undergoing fiberoptic bronchoscopy
10.3760/cma.j.cn131073-20241003-00913
- VernacularTitle:瑞马唑仑和丙泊酚镇静对纤维支气管镜诊疗术患者肺通气影响的比较
- Author:
Lan ZHANG
1
;
Yingcong QIAN
1
;
Yongheng HOU
1
;
Jianping YANG
1
;
Jian LI
1
Author Information
1. 苏州大学附属第四医院（苏州市独墅湖医院）麻醉科，苏州 215000
- Publication Type:Journal Article
- Keywords:
Benzodiazepines;
Propofol;
Bronchoscopy;
Pulmonary ventilation
- From:
Chinese Journal of Anesthesiology
2025;45(9):1157-1161
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of remimazolam and propofol sedation on pulmonary ventilation in patients undergoing fiberoptic bronchoscopy.Methods:In this randomized controlled trial, 90 American Society of Anesthesiologists Physical Status classification Ⅰ to Ⅲ patients, aged 18-70 yr, with a body mass index of 18-30 kg/m 2, scheduled for elective fiberoptic bronchoscopy and/or treatment under sedation at the Endoscopy Center of the Fourth Affiliated Hospital of Soochow University between November 2021 and December 2022, were divided into 2 groups ( n=45 each) using a random number table: remimazolam group (group R) and propofol group (group P). After intravenous injection of sufentanil 0.1 μg/kg, an initial dose of remimazolam 0.075 mg/kg and propofol 0.9 mg/kg was intravenously injected in group R and group P, respectively. When necessary, additional single doses of remimazolam 0.025 mg/kg or propofol 0.3 mg/kg were administered until the bispectral index value reached 60–80 and the Modified Observer′s Assessment of Alertness/Sedation score was ≤3 (successful sedation). Electrical impedance tomography was conducted immediately after entering the operating room, immediately after successful sedation, immediately after completion of bronchoscopy the procedure, and immediately upon awakening to calculate the tidal impedance variation, center of ventilation, and global inhomogeneity index. The time to successful sedation, emergence time, the lowest SpO 2 during sedation, and occurrence of adverse events such as respiratory depression, injection pain, hypotension, hypertension, tachycardia, bradycardia and dizziness were recorded. Results:Compared with group P, the tidal impedance variation was significantly increased immediately after the procedure, the global inhomogeneity index was decreased immediately after the procedure and upon awakening, the emergence time was prolonged, the lowest SpO 2 was elevated, and the incidence of hypotension and injection pain was decreased in group R ( P<0.05). Conclusions:Compared with propofol sedation, remimazolam sedation has a smaller impact on pulmonary ventilation in patients undergoing fiberoptic bronchoscopy.
