Conscious sedation with midazolam and dezocine for diagnostic flexible bronchoscopy.

OBJECTIVE

This study aimed to assess the benefits and risks of conscious sedation with midazolam and dezocine in diagnostic flexible bronchoscopy (FB).

PATIENTS AND METHODS

This prospective case control study enrolled 40 non-sedated and 40 sedated subjects who underwent diagnostic FB. All received the standard upper airway preparation, while sedated subjects received midazolam and dezocine for conscious sedation. Subject discomforts during FB were assessed using the verbal analogue score (VAS, 0-10 scale). Willingness to return was assessed as five scales to monitor subject's satisfaction level. Safety profiles throughout the procedures were also assessed.

RESULTS

Anterograde amnesia existed in 75.0% sedated subjects. Compared to non-sedated subjects, sedated ones expressed less discomfort, with lower VAS scores regarding scope insertion (4 [0-10] vs. 0 [0-4], p < 0.001), cough (5.5 [0-10] vs. 0 [0-4], p < 0.001), dyspnea (3.5 [0-10] vs. 0 [0-4], p<0.001), pain (3 [0-10] vs. 0 [0-5], p < 0.001), and global tolerance of the procedures (5.5 [1-10] vs. 0 [0-5], p < 0.001). More sedated subjects expressed willingness to return (90.0% vs. 30.0%, p < 0.001). Sedated subjects had no more hypoxemic episodes during the procedure (7.5% vs. 5.0%, p > 0.99), which were all transient and not life-threatening.

CONCLUSIONS

Conscious sedation with midazolam and dezocine reduces discomforts, improves satisfaction level, and carries no significantly risks in subjects undergoing diagnostic FB.