What is it about?
Dexmedetomidine for Awake Bronchoscopy: Our Experience
Featured Image
Photo by Wan Salahuddin Wan Ismail on Unsplash
Why is it important?
Background: Respiratory physicians are showing interest in using Dexmedetomidine for awake sedation, since, it is safe and useful when the patient is having spontaneous breathing and also cost-effective. We evaluated the safety and efficacy of dexmedetomidine in a small cohort of thirty patients undergoing awake bronchoscopy under topical anaesthesia using 10% Xylocaine. Methods: Premedication was with midazolam and rescue medication was fentanyl. Dexmedetomidine was infused at one g/kg infused over 10 minutes. The bronchoscope was inserted after bolus infusion followed by maintenance infusion of Dexmedetomidine started with 0.2g/kg/h and titrated optionally to 0.7g/kg/h. We recorded the pre- and intraprocedural vital signs and Ramsay sedation score were recorded every 10 minutes, in addition to adverse events, duration of the procedure, use of rescue sedation with fentanyl one g/kg, and physicians and patient’s satisfaction. Patients were discharged as per the modified post anesthetic discharge scoring system. Results: Mean Duration of procedure was 30±10 min. Percentage of patients requiring rescue sedation was 3/30 (10%). 3/30 (10%) of patients had hypotension, 6/30 (20%) had bradycardia and 1/30 (3.3%) had amnesia. The mean time to recovery was 25±10 min. The physician and patient’s satisfaction score (range, 1 to 5) were five and four respectively. Conclusion: Dexmedetomidine alone is safe, provides satisfaction to both doctors and patients, with fewer anticipated and spontaneously recoverable side effects.
Perspectives
Background: Respiratory physicians are showing interest in using Dexmedetomidine for awake sedation, since, it is safe and useful when the patient is having spontaneous breathing and also cost-effective. We evaluated the safety and efficacy of dexmedetomidine in a small cohort of thirty patients undergoing awake bronchoscopy under topical anaesthesia using 10% Xylocaine. Methods: Premedication was with midazolam and rescue medication was fentanyl. Dexmedetomidine was infused at one g/kg infused over 10 minutes. The bronchoscope was inserted after bolus infusion followed by maintenance infusion of Dexmedetomidine started with 0.2g/kg/h and titrated optionally to 0.7g/kg/h. We recorded the pre- and intraprocedural vital signs and Ramsay sedation score were recorded every 10 minutes, in addition to adverse events, duration of the procedure, use of rescue sedation with fentanyl one g/kg, and physicians and patient’s satisfaction. Patients were discharged as per the modified post anesthetic discharge scoring system. Results: Mean Duration of procedure was 30±10 min. Percentage of patients requiring rescue sedation was 3/30 (10%). 3/30 (10%) of patients had hypotension, 6/30 (20%) had bradycardia and 1/30 (3.3%) had amnesia. The mean time to recovery was 25±10 min. The physician and patient’s satisfaction score (range, 1 to 5) were five and four respectively. Conclusion: Dexmedetomidine alone is safe, provides satisfaction to both doctors and patients, with fewer anticipated and spontaneously recoverable side effects.
Red Flower Publication Publications
Red Flower Publication Pvt Ltd
Read the Original
This page is a summary of: Dexmedetomidine for Awake Bronchoscopy: Our Experience, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5118.2.
You can read the full text:
Contributors
The following have contributed to this page
