title: Efficacy of target-controlled infusion of propofol and remifentanil with high frequency jet ventilation in fibre-optic bronchoscopy.
abstract: BACKGROUND
  Sedation or anaesthesia is recommended for all patients undergoing bronchoscopy unless absolute contraindications exist. However, the widely used combination of propofol and opiates for moderate sedation (MS) in bronchoscopy results in a high incidence of hypoxaemia and a relatively high cough score during the procedure. In this study, we evaluated the efficacy and safety of target-controlled infusion (TCI) of propofol and remifentanil, together with the use of high frequency jet ventilation (HFJV), to achieve general anesthesia (GA) in diagnostic fibre-optic bronchoscopy.
  
  
  METHODS
  A total of 92 consecutive patients scheduled for flexible bronchoscopy were randomly assigned to receive either MS using TCI-delivered propofol and remifentanil (n = 46), or GA using TCI-delivered propofol and remifentanil with HFJV (n = 46). The following were compared between the MS and GA groups: incidence of hypoxaemia, cough score, haemodynamic parameters, partial pressure of carbon dioxide in arterial blood, duration of bronchoscopy and patient satisfaction score.
  
  
  RESULTS
  The average and minimum oxygen saturation values in the MS group were lower than those in the GA group. The MS group showed a higher incidence of hypoxaemia. There was no significant difference in the partial pressure of carbon dioxide between the two groups. Cough score and duration of the bronchoscopy were markedly lower in the GA group, and patient satisfaction score was higher in the GA group.
  
  
  CONCLUSIONS
  GA, achieved via TCI-delivered propofol and remifentanil with HFJV, provides better conditions for diagnostic bronchoscopy - it decreases the occurrence of hypoxaemia, shortens the duration of bronchoscopy and increases patient satisfaction.
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Hanbing
authors.initials: H
authors.lastname: Wang
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Chengxiang
authors.initials: C
authors.lastname: Yang
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Hongzhen
authors.initials: H
authors.lastname: Liu
authors.affiliation: Foshan Hospital, Sun Yat-Sen University, 81 North Lingnan Road, Foshan City 528000, Guang Dong Province, China. lhlh2003@126.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Liang
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001999:Bronchoscopy / Q000379:methods*; D002245:Carbon Dioxide / Q000737:chemistry; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D006439:Hemodynamics; D006611:High-Frequency Jet Ventilation / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D000860:Hypoxia; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D010880:Piperidines; D002245:Carbon Dioxide; D000077208:Remifentanil; D010100:Oxygen; D015742:Propofol