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Flexible bronchoscopy may decrease respiratory muscle strength: premedicational midazolam in focus

Baykal Tulek1, Fikret Kanat, Sule Tol

  • 1Selcuk University, Selcuklu Faculty of Medicine, Department of Chest Diseases, Selçuklu, 42075, Konya, Turkey. baykaltulek@yahoo.com.

Multidisciplinary Respiratory Medicine
|September 27, 2012
PubMed
Abstract

Insights

Flexible bronchoscopy (FB) can cause temporary respiratory muscle weakness, particularly with higher doses of midazolam sedation. This weakness may contribute to hypoventilation in vulnerable patients post-procedure.

Area of Science:

  • Pulmonology
  • Anesthesiology
  • Respiratory Medicine

Background:

  • Flexible bronchoscopy (FB) is generally safe with low complication rates.
  • Patients with respiratory failure may experience hypoventilation after FB.
  • This study investigates FB's impact on respiratory muscle strength.

Purpose of the Study:

  • To assess the effect of flexible bronchoscopy on respiratory muscle strength.
  • To determine the influence of midazolam sedation on post-procedure respiratory muscle function.

Main Methods:

  • 140 patients (25-90 years) undergoing diagnostic FB were studied.
  • Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured pre- and post-procedure.
  • Correlations between pressure changes, patient characteristics, and FB variables were analyzed.

Main Results:

  • Significant decreases in MIP and MEP were observed post-FB (p < 0.001).
  • Decreases were linked to midazolam sedation.
  • Higher midazolam doses correlated with greater reductions in respiratory muscle strength.

Conclusions:

  • Flexible bronchoscopy can lead to post-procedure respiratory muscle weakness.
  • Midazolam premedication is a key factor in this weakness.
  • Respiratory muscle weakness may contribute to hypoventilation in critical patients undergoing FB.

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