Sedation with midazolam in flexible bronchoscopy: a prospective study

Area of Science:

• Pulmonology
• Anesthesiology
• Clinical Pharmacology

Background:

• Flexible bronchoscopy (FOB) often requires sedation for patient comfort.
• Midazolam is a common sedative due to its rapid onset, anxiolytic, and amnestic effects.

Purpose of the Study:

• To evaluate midazolam's effect on patient tolerance during FOB.
• To assess complications and the feasibility of routine midazolam use in FOB.

Main Methods:

• A multi-center, randomized, placebo-controlled study involving 100 patients undergoing FOB.
• Patients received either midazolam (0.05mg/kg) or a saline placebo before the procedure.
• Anxiety levels were assessed using the Hospital Anxiety and Depression Scale (HADS-A), and subjective questionnaires were used.

Main Results:

• Midazolam group showed significantly less cough (32% vs 56%) and dyspnea (2% vs 34%) compared to placebo.
• No significant differences in FOB duration, procedure type, lidocaine dosage, or overall complications were observed.
• Patients receiving midazolam reported higher willingness to repeat the exam (100% vs 82%).

Conclusions:

• Midazolam sedation enhances patient comfort and reduces symptoms like cough and dyspnea during FOB.
• The study found no significant adverse hemodynamic changes with midazolam use.
• Routine administration of midazolam for flexible bronchoscopy is recommended to improve patient experience.