Meta-analysis of the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy

To perform a meta-analysis on the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy.

Relevant literature on the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy was searched in both Chinese and English databases.

A total of 19 studies published between 2012 and 2024 were included, involving 38 groups and 2,339 patients. Meta-analysis of continuous variables from fifteen studies reported no statistically significant difference in systolic blood pressure between the study group and the control group (MD = -0.27, 95% CI: -2.16 to 1.61, Z = -0.28, P = 0.78). Similarly, eight studies showed no significant difference in heart rate between the study group and the control group (MD = -0.62, 95% CI: -2.67 to 1.43, Z = -0.59, P = 0.55). Twelve studies demonstrated significantly higher oxygen saturation (SaO2) levels in the study group compared to the control group (MD = 1.88, 95% CI: 0.56 to 3.20, Z = 2.79, P = 0.01). Nine studies indicated that sedation satisfaction was significantly higher in the study group than in the control group (MD = 2.93, 95% CI: 1.16 to 4.70, Z = 3.25, P < 0.01). Ten studies assessed sedation scores, showing no statistically significant difference between groups (MD = 0.32, 95% CI: -0.02 to 0.67, Z = 1.82, P = 0.07). Awakening time, reported in eight studies, also showed no significant difference (MD = -2.70, 95% CI: -5.50 to 0.09, Z = -1.89, P = 0.06). Six studies reported VAS (Visual Analogue Scale) scores, showing a statistically significant difference (MD = -0.46, 95% CI: -0.83 to -0.08, Z = -2.39, P = 0.02). Meta-analysis of dichotomous variables from fourteen studies showed no significant difference in the incidence of adverse events between the groups (OR = -0.10, 95% CI: -0.49 to 0.29, Z = -0.49, P = 0.62). Meta-regression analysis suggested that heterogeneity mainly originated from differences in study type and methodology (P < 0.05).

Both midazolam and dexmedetomidine demonstrate good sedative effects during bronchoscopy, and their use should be tailored to individual patient conditions.