title: [A randomised study of midazolam for sedation in flexible bronchoscopy].
abstract: BACKGROUND
  Flexible bronchoscopy (FB) is a procedure which is not usually tolerated well by the patient. This makes the examination more difficult, often needing repetition with the subsequent lowering of diagnostic performance.
  
  
  OBJECTIVE
  The principal aim of our study is to analyse whether the use of a local anaesthetic with midazolam whilst performing an FB improves the quality of examination in terms of patient tolerance. Also of interest was to find out if this would improve the acceptance of a second or further FB, and the satisfaction of the bronchoscopist in performing these examinations.
  
  
  METHODS
  A randomised, double blind and controlled with placebo, prospective study has been carried out to assess the use of midazolam. This included 152 patients, randomised into two groups: Group A-79 (51.9%) patients who received midazolam before the FB, and Group B-73 (49.1%) patients who received placebo. The patients were given a questionnaire about different aspects of perception of the procedure after the respiratory endoscopy and another was given to the bronchoscopist.
  
  
  RESULTS
  Both groups started off with a similar assessment of fear and nervousness. Group A gave a much higher score than Group B referring to variables related to symptoms and feeling. Patient cooperation assessed by the bronchoscopist was similar in both groups, although the length of the procedure and difficulty was higher in group B.
  
  
  CONCLUSIONS
  Our results show that patients sedated with midazolam tolerate FB better, remember less of the procedure itself and have a better predisposition to repeat the procedure. The bronchoscopist has less difficulties during the procedure and shortens the time using the same techniques during the bronchoscopy. The lack of severe complications and these results suggest the use of sedation with midazolam as routine during FB.
authors.affiliation: Hospital Universitario La Fe, Valencia, España. cases_enr@gva.es
authors.forename: Enrique
authors.initials: E
authors.lastname: Cases Viedma
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez Pallarés
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martínez García
authors.forename: Raquel
authors.initials: R
authors.lastname: López Reyes
authors.forename: Francisca
authors.initials: F
authors.lastname: Sanchís Moret
authors.forename: José Luis
authors.initials: JL
authors.lastname: Sanchís Aldás
mesh_terms: D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods; D016292:Procedural Sedation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam