Safety and efficacy of dexmedetomidine sedation for elective fiberoptic bronchoscopy: A comparative study with propofol

Background: Dexmedetomidine has sedative and sympatholytic effects. The use of dexmedetomidine in flexible fiberoptic bronchoscopy will attenuate hemodynamic response without respiratory depression. The aim of this study was to evaluate the clinical efficiency and safety of dexmedetomidine, and to compare it with the combination of propofol-fentanyl as sedation during flexible fiberoptic bronchoscopy. Patients and methods: Seventy-two patients scheduled for elective fiberoptic bronchoscopy were included and divided into two equal groups. In propofol-fentanyl group (group PF) patients received 0.5-1 mg/kg propofol and 1 mu g/kg of fentanyl. Boluses of 20 mg of propofol were given to give a sedation level of 3-4 according to Ramsay sedation score. In dexmedetomidine group (group D), dexmedetomidine 1 mu g/kg over 10 min was given as a loading dose, followed by a maintenance infusion of 0.2-0.7 mu g/kg/h to keep the same level of sedation. Heart rate, blood pressure and oxygen saturation were recorded. Results: Heart rate and mean arterial blood pressure values were significantly lower in group D compared to group PF all over the procedure. Group D had higher oxygen saturation values than group PF. Incidence of desaturation was more frequent in PF group (16.66%) compared to 5.55% in group D. There was no significant difference in patient satisfaction between the two groups. Conclusion: Dexmedetomidine and propofol-fentanyl are effective sedatives for patients undergoing flexible fiberoptic bronchoscopy. The sympatholytic and respiratory stability effects of dexmedetomidine make it an attractive and safe alternative for sedation during FOB. (C) 2016 Publishing services by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.