Propofol versus dexmedetomidine as a sole sedativefor diagnostic flexible bronchoscopy: a randomizeddouble-blind study

ContextSedation is commonly used to improve patients’ tolerance and comfort during flexible bronchoscopy (FB). Dexmedetomidine is a relatively novel sedative for use in FB.AimsThe aim of this study was to compare dexmedetomidine and propofol as sole sedative agent in terms of hemodynamics, efficacy, safety and tolerance to the procedure among patients undergoing FB. Settings and designThis study was carried out in a tertiary care teaching hospital, and was a double-blind randomized-controlled trial.Patients and methodsSixty patients were analyzed. Group 1 received propofol (1 mg/kg bolus, then 5 mg/kg/h infusion); group 2 received dexmedetomidine (1 μg/kg bolus, followed by 0.7 μg/kg/h infusion). Intraoperative (IOP) SpO , heart rate, mean arterial pressure, and respiratory rate were recorded at nine time points. Primary outcome variables were hemodynamic variables, level of sedation, and recovery time (to reach an Aldrete score 10/10).ResultsThe dexmedetomidine group showed significantly lower mean heart rate than the propofol group at IOP , IOP , and IOP . The mean arterial pressure was significantly higher throughout0 2 4the procedure in the dexmedetomidine group compared with the propofol group (P 0.001). A significant decrease in respiratory rate was noted in the dexmedetomidine group at IOP and IOP (P 0.001). The lowest mean SpO was noted in the dexmedetomidine group (97.0 ± 1.1).6 2Incidences of bucking and coughing were significantly higher in the dexmedetomidine group. Bronchoscopist visual analogue scale scores for coughing and satisfaction were significantly lower in the propofol group (P 0.001). Recovery time was shorter in the propofol group [3 (1.2) vs. 4.5 (1.1) min] (P 0.001).ConclusionPropofol showed superiority over dexmedetomidine in terms of safety, efficacy, adverse-effect profile, and tolerance to the procedure in patients undergoing diagnostic flexible bronchoscopy.