Dexmedetomidine as sedative agent for flexible bronchoscopy: efficacy and patient satisfaction

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Introduction: Dexmedetomidine, an a2-adrenoceptor agonist is considered a safe sedative option for procedural conscious sedation, including bronchoscopy. Aims and objectives: This study sought to investigate the efficacy of dexmedetomidine as a sedative agent during bronchoscopy focusing primarily on monitoring vital signs, bronchoscopy duration, sedation outcome and patient satisfaction. Methods: A total of 281 patients that underwent diagnostic bronchoscopy were included. Among them, 153 patients (Group D) received dexmedetomidine in addition to local anesthesia while 128 patients (Group C) received midazolam alongside local anesthesia, following local sedation protocols. Dexmedetomidine administration included a loading dose of 0.6-1mcg/kg followed by continuous infusion of 0.4-0.8 mcg/kg/hr. Results: There was no significant difference in SpO2 levels between the two groups. Maximum heart rate and blood pressure post-bronchoscopy were lower in Group D than in Group C (90 vs 98 bpm and 115/70 vs 140/80mmHg, respectively). The minimum heart rate recorded in Group D was 72bpm (60-83bpm). Bronchoscopy duration was similar between the groups. Improved sedation outcomes were noted in Group D with 21% of patients achieving a Ramsay scale score of ≥3, compared to 3% in Group C. Patient compliance was rated as good/very good in 71% of Group D patients, versus 54% in Group C. 43% of Group D patients expressed willingness to repeat potential bronchoscopy in the future, as opposed to 26% in Group C. Conclusions: The use of dexmedetomidine during bronchoscopy was associated with reduced incidence of tachycardia and hypertension, yielded satisfactory sedation outcomes, and enhanced patient comfort.

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