title: Safety and discomfort during bronchoscopy performed under sedation with fentanyl and midazolam: a prospective study.
abstract: OBJECTIVE
  Although sedation with fentanyl and midazolam during bronchoscopic examination is widely accepted in the USA and Europe, it is not routine practice in Japan. The objective of the present study was to evaluate sedation with fentanyl and midazolam during bronchoscopy.
  
  
  METHODS
  Thirty-seven patients were enrolled prospectively between November 2014 and July 2015 at Okayama University Hospital. Fentanyl (20 μg) was administered to the patients just before the examination, and fentanyl (10 μg) and midazolam (1 mg) were added as needed during the procedure. A questionnaire was administered 2 hours after the examination. In the questionnaire, patient satisfaction was scored using a visual analog scale as follows: great (1 point), good (2 points), normal (3 points), uncomfortable (4 points) and very uncomfortable (5 points). An additional question ('Do you remember the bronchoscopic examination?') was also used. Predefined matters for investigation (e.g. blood pressure, heart rate, oxygen saturation and complications) were recorded.
  
  
  RESULTS
  The enrolled patients included 13 males and 24 females; the median age was 67 (range: 31-87) years. The patients received a median dose of fentanyl of 45.4 μg (range: 30-100 μg) and midazolam of 2.56 mg (range: 1-10 mg). Twenty-six patients (70.2%) agreed to undergo a second bronchoscopic examination, and the average levels of discomfort and re-examination were 2.02 points for each. Only 37.8% of the patients remembered the bronchoscopic examination. No severe complications were reported.
  
  
  CONCLUSIONS
  Sedation with fentanyl and midazolam during bronchoscopic examination should be recommended for use in Japan.
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama d-minami@bj8.so-net.ne.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Minami
authors.affiliation: Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan.
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Kadoaki
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hotta
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tabata
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.affiliation: Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Hospital, Okayama.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006439:Hemodynamics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008171:Lung Diseases / Q000175:diagnosis; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl
keywords: clinical trials; endoscopy-respiratory tract; interventional pulmonology; sedation