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Korean J Anesthesiol > Volume 56(1); 2009 > Article
Korean Journal of Anesthesiology 2009;56(1):1-5.
DOI: https://doi.org/10.4097/kjae.2009.56.1.1   
The effect of midazolam premedication on patient satisfaction during fiberoptic bronchoscopy under patient-controlled sedation.
Won Kyoung Kwon, Eun Su Choi, Ji Young Kim, Sang Ri Park, Hyo Seok Na, Sang Hyun Park, Hee Pyoung Park, Young Tae Jeon, Jung Won Hwang
1Department of Anesthesiology and Pain Medicine, College of Medicine, Konkuk University, Seoul, Korea.
2Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.
3Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam, Korea. ytjeon@snubh.org
Patient-controlled sedation (PCS) with propofol is a safe and effective method of attenuating discomfort during fiberoptic bronchoscopy. The purpose was to evaluate the usefulness of midazolam in addition to PCS for fiberoptic bronchoscopy.
We randomly assigned 155 patients undergoing diagnostic bronchoscopy to two groups. Group M (n = 79) received 0.03 mg/kg of midazolam for premedication while group P (n = 76) received a loading dose (0.05 ml/kg) of PCS solution composed of 200 mg (20 ml) of propofol and 1 mg (2 ml) of alfentanil. Both groups received the PCS solution 0.2 ml/kg/hr with a bolus of 1 ml and a lockout time of 1 min. Vital signs, pulmonologist satisfaction, patient satisfaction and amnesia were evaluated.
After the insertion of the bronchoscope, there was a slight decrease of SpO2 and an increase of blood pressure and heart rate in both groups with no significant differences between the two groups. The group P required more bolus injections (1.6 +/- 1.7 in the group M vs 2.5 +/- 2.2 in group P; P < 0.05). There was no difference in the satisfaction of pulmonologists, but the satisfaction of patients was higher in the group M (P < 0.05). More patients in the group P (93%) remembered the procedure than in the group M (70%) (P < 0.05).
PCS is an effective method for sedating patients undergoing fiberoptic bronchoscopy and midazolam provides more patient satisfaction and amnesia.
Key Words: Alfentanil; Bronchoscopy; Midazolam; Patient-controlled sedation; Propofol
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