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Patient-controlled Sedation During Flexible Bronchoscopy: A Randomized Controlled Trial.

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Journal of Bronchology & Interventional Pulmonology
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Patient-controlled sedation (PCS) with propofol during flexible bronchoscopy (FB) significantly speeds up patient recovery. This method ensures similar satisfaction for patients and bronchoscopists compared to traditional sedation.

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Area of Science:

  • Pulmonology
  • Anesthesiology
  • Gastroenterology

Background:

  • Patient-controlled sedation (PCS) is recognized for enhancing recovery post-endoscopic procedures.
  • Data on PCS application during flexible bronchoscopy (FB) remains limited.

Purpose of the Study:

  • To evaluate if PCS with propofol during FB improves early recovery.
  • To compare patient and bronchoscopist satisfaction between PCS and nurse-controlled sedation (NCS).

Main Methods:

  • 150 patients were randomized into three groups: control (morphine-scopolamine, NCS midazolam), PCS-MS (morphine-scopolamine, PCS propofol), and PCS-G (glycopyrronium, PCS propofol).
  • Procedures included transbronchial biopsy, needle aspiration, cryotherapy/biopsy, and endobronchial ultrasound.

Main Results:

  • 81% of patients in PCS groups were ready for discharge within 2 hours, versus 40% in the control group (P<0.0001).
  • The PCS-G group showed higher discharge readiness (96%) compared to PCS-MS (65%) at 2 hours (P=0.0002).
  • High satisfaction scores were reported by both patients and bronchoscopists across all groups, with no significant differences in post-discharge quality.

Conclusions:

  • PCS with propofol is a feasible and effective sedation method for FB, accelerating recovery without negatively impacting procedural conditions.
  • Rapid stabilization of vital signs post-sedation aids in efficient patient surveillance and discharge planning.