[A randomised study of midazolam for sedation in flexible bronchoscopy].
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.
Cases Viedma
Enrique
E
Hospital Universitario La Fe, Valencia, España. cases_enr@gva.es
Pérez Pallarés
Javier
J
Martínez García
Miguel Angel
MA
López Reyes
Raquel
R
Sanchís Moret
Francisca
F
Sanchís Aldás
José Luis
JL
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
D006993:Hypnotics and Sedatives; D008874:Midazolam