title: Randomized double-blind study of remifentanil and dexmedetomidine for flexible bronchoscopy.
abstract: BACKGROUND
  The safety profiles and efficacies of remifentanil and dexmedetomidine (a sedative-analgesic without respiratory depression) for sedation during flexible bronchoscopy were investigated.
  
  
  METHODS
  Seventy-two patients undergoing elective flexible bronchoscopy were randomly assigned to a propofol-remifentanil group (Group PR, n=36) or a propofol-dexmedetomidine group (Group PD, n=36). The primary outcome was the incidence of oxygen desaturation. Haemodynamic variables, adverse events, need of oral cavity suction, cough scores, satisfaction scores of patients and bronchoscopists, levels of sedation, and recovery times were also compared.
  
  
  RESULTS
  The incidence of oxygen desaturation was significantly lower in the PD group than in the PR group (P=0.01). There were no significant differences between groups in terms of level of sedation, oxygen saturation, mean arterial pressure, heart rate over time, cough scores, or patient satisfaction scores (P>0.05). However, cough scores and bronchoscopist satisfaction scores (P<0.01) were lower in the PD group. In addition, topical anaesthesia (P<0.01) was required more frequently and recovery time (P=0.00) was significantly longer in the PD group. However, oral suction (P=0.03) was required less frequently in the PD group.
  
  
  CONCLUSIONS
  Dexmedetomidine was associated with fewer incidents of oxygen desaturation and a reduced need for oral cavity suction than remifentanil during flexible bronchoscopy. However, dexmedetomidine was associated with a longer recovery time and poorer bronchoscopist satisfaction score.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Ryu
authors.forename: S W
authors.initials: SW
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: E H
authors.initials: EH
authors.lastname: Lee
authors.forename: S H
authors.initials: SH
authors.lastname: Do
authors.forename: C S
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic; D000762:Anesthesia Recovery Period; D001794:Blood Pressure / Q000502:physiology; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods*; D003371:Cough / Q000517:prevention & control; D020927:Dexmedetomidine; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives; D000860:Hypoxia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D017060:Patient Satisfaction; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D006993:Hypnotics and Sedatives; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil; D010100:Oxygen; D015742:Propofol