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

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

Table 1 Ramsay sedation scale [11].

1	Patient is anxious or agitated
2	Patient is cooperative, oriented and tranquil
3	Patient responds to commands only
4	Patient exhibits brisk response to light glabellar tap or loud auditory stimulus
5	Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus
6	Patient exhibits no response

Table 2 Comparison between the two intervention groups (Dexmedetomidine) and (Propofol-fentanyl) as regard Age, Sex, Weight, Time to start Procedure, Duration of FOB.

Patient Characteristics	Group D (n = 36)		Group PF (n = 36)		t-Value	P-value
Age (years)	50.3 ± 14.9		47.9 ± 15.3		0.502	0.619
Sex	No	%	No	%	CHI^2 value^⁎
Male	23	63.9	25	69.4	0.250	0.617
Female	13	36.1	11	30.6
Weight (kg)	77.9 ± 14.2		80.3 ± 14.0		−0.536	0.595
Time to start procedure (min)	10.5 ± 2.1		2.7 ± 0.73		15.431	0.000^⁎
Duration of FOB (min)	21.8 ± 3.9		21.5 ± 3.6		0.251	0.803

Values are presented as Mean ± SD or number (%).

⁎ Chi square test.

Table 3 Comparison between the two intervention groups (Dexmedetomidine) and (Propofol-fentanyl) as regard HR.

HR (BPM)	Group D (n = 36)	Group PF (n = 36)	t-Value	P-value
Baseline	86.0 ± 13.9	86.5 ± 14.1	−0.101	0.920
After Sedation (T1)	66.3 ± 10.5	77.5 ± 12.9	−3.002	0.0055^⁎
At the start of FOB (T2)	85.6 ± 8.1	96.8 ± 11.9	−3.464	0.001^⁎
3 Min	79.5 ± 7.4	93.5 ± 8.9	−5.365	0.000^⁎
6 Min	78.3 ± 7.7	89.3 ± 7.6	−4.518	0.000^⁎
9 Min	75.5 ± 8.4	89.3 ± 8.2	−5.218	0.000^⁎

Values are presented as Mean ± SD.

BPM: Beat per minute.

After sedation (T1): the time the patients achieved a sedation score of 3.

At the start of FOB (T2): during advancing the bronchoscope through the vocal cords.

⁎ Statistically significant at P < 0.05.

Table 4 Comparison between the two intervention groups (Dexmedetomidine) and (Propofol + fentanyl) as regards MAP.

MAP (mmHg)	Group D (n = 36)	Group PF (n = 36)	t-value	P-value
Baseline	90.9 ± 8.2	88.9 ± 8.5	0.772	0.445
After sedation (T1)	86.4 ± 6.8	80.4 ± 8.9	2.384	0.022^⁎
At the start of FOB (T2)	86.4 ± 6.8	95.1 ± 8.1	−3.624	0.001^⁎
3 min	80.7 ± 7.0	89.2 ± 7.8	−3.606	0.001^⁎
6 min	78.0 ± 7.7	87.3 ± 7.4	−3.865	0.000^⁎
9 min	77.3 ± 7.2	89.3 ± 8.0	−4.973	0.000^⁎

Values are presented as Mean ± SD.

HR: heart rate.

MAP: mean arterial pressure.

After sedation (T1): the time the patients achieved a sedation score of 3.

At the start of FOB (T2): during advancing the bronchoscope through the vocal cords.

⁎ Statistically significant at P < 0.05.

Table 5 Comparison between the two intervention groups (Dexmedetomidine) and (Propofol-fentanyl) as regards O2 saturation.

O2 Saturation (%)	Group D (n = 36)	Group PF (n = 36)	t-Value	P-value
Baseline	96.7 ± 1.8	97.1 ± 1.8	−0.756	0.454
After sedation (T1)	96.2 ± 1.8	96.2 ± 1.8	0.000	1.000
At the start of FOB (T2)	93.4 ± 2.8	90.9 ± 3.9	2.286	0.028^⁎
3 Min	95.6 ± 1.8	93.6 ± 2.6	2.845	0.007^⁎
6 min	95.6 ± 1.7	95.2 ± 1.6	0.643	0.524
9 min	96.0 ± 1.7	95.2 ± 1.6	1.551	0.129

Values are presented as Mean ± SD.

After sedation (T1): the time the patients achieved a sedation score of 3.

At the start of FOB (T2): during advancing the bronchoscope through the vocal cords.

⁎ Statistically significant at P < 0.05.

Table 6 Comparison between the two intervention groups (Dexmedetomidine) and (Propofol + fentanyl) as regard incidence of complications and patient satisfaction.

Type of complications		Group		P-value
		Group D (n = 36)	Group PF (n = 36)
Bradycardia HR < 55 bpm	No	8	2	0.084
	%	22.22%	5.55%
Hypotension MBP < 55 mmHg	No	6	3	0.478
	%	16.66%	8.33%
O2 desaturation (apnea or airway obstruction that needs mask ventilation)	No	2	6	0.260
	%	5.55%	16.66%
Patient satisfaction				0.883
Satisfied	30 (83%)		29(80.5%)
Neutral	5 (14%)		5 (14%)
Unsatisfied	1(3%)		2(5.5%)

Fisher Exact Test was used as expected count less than 5.

bpm: beat per minute.