Your browser doesn't support javascript.
loading
Fixed dexmedetomidine infusion versus fixed-dose midazolam bolus as primary sedative for maintaining intra-procedural sedation during endobronchial ultrasound-guided transbronchial needle aspiration: a double blind randomized controlled trial.
Kumari, Renu; Jain, Kajal; Agarwal, Ritesh; Dhooria, Sahajal; Sehgal, Inderpaul Singh; Aggarwal, Ashutosh Nath.
Affiliation
  • Kumari R; Pulmonary Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Jain K; Anesthesiology and Intensive Care Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Agarwal R; Pulmonary Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Dhooria S; Pulmonary Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Sehgal IS; Pulmonary Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Aggarwal AN; Pulmonary Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Expert Rev Respir Med ; 15(12): 1597-1604, 2021 12.
Article in En | MEDLINE | ID: mdl-33849367
Objective: The utility and safety of fixed dexmedetomidine infusion was compared to fixed-dose midazolam bolus among patients undergoing EBUS-TBNA.Methods: In this randomized double-blind study, 197 patients were assigned to receive dexmedetomidine (Group D, 1 µg/kg before, and 0.6 µg/kg/hour during, procedure) or midazolam (Group M, 2 mg before procedure) sedation. The primary outcome was number of rescue midazolam boluses administered to achieve Ramsay Sedation Scale (RSS) score of two or more. We also studied sedation depth during procedure, adverse hemodynamic and hypoxemic events, bronchoscopist and patient satisfaction, and time-to-discharge from recovery room.Results: Rescue midazolam requirement was significantly lesser in 99 Group D (0.9 ± 1.2 boluses) than in 98 Group M (2.0 ± 2.4 boluses), subjects. Mean RSS score was significantly higher in Group D subjects (2.5 ± 0.7 vs. 2.3 ± 0.7). Significantly more subjects in Group D developed hypotension (46 vs. 27) or bradycardia (37 vs. 5), but none required specific intervention. Bronchoscopists reported significantly greater overall procedure satisfaction in Group D subjects.Conclusion: Fixed dexmedetomidine infusion reduced need for rescue sedation during EBUS-TBNA, and allowed slightly faster post-procedure recovery, as compared to fixed-dose midazolam bolus. However, it caused hypotension and bradycardia more frequently.Clinical trial registration: www.clinicaltrials.gov identifier is NCT02713191.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Midazolam / Dexmedetomidine Type of study: Clinical_trials / Prognostic_studies Limits: Humans Language: En Journal: Expert Rev Respir Med Year: 2021 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Midazolam / Dexmedetomidine Type of study: Clinical_trials / Prognostic_studies Limits: Humans Language: En Journal: Expert Rev Respir Med Year: 2021 Document type: Article