Kumar Amarjeet, Kumari Poonam, Sinha Chandni, Kumar Ajeet, Karmakar Saurabh
Department of Trauma and Emergency, AIIMS, Patna, Bihar, India.
Department of Anaesthesia, AIIMS, Patna, Bihar, India.
J Anaesthesiol Clin Pharmacol. 2024 Jan-Mar;40(1):56-62. doi: 10.4103/joacp.joacp_60_22. Epub 2024 Mar 14.
Mild to moderate sedation during bronchoscopy is essential for patient safety, comfort during and after the procedure, and to facilitate the performance of the bronchoscopist. Dexmedetomidine is a highly selective, centrally acting α-2 agonist used to provide conscious sedation during various procedures. The aim of this study was to compare the efficacy of three different doses of dexmedetomidine nebulization as an adjuvant to lignocaine during bronchoscopy.
Ninety American Society of Anesthesiologists physical status I/II patients, aged from 18 to 60 years, scheduled for an elective bronchoscopy, were recruited. They were divided into three groups: 30 patients in each group. Group I: The patient was nebulized with a mixture of 4 ml of 4% lignocaine and dexmedetomidine 0.5 μg/kg. Group II: The patient was nebulized with a mixture of 4% lignocaine, 4 ml, and dexmedetomidine, 1 μg/kg. Group III: The patient was nebulized with 4% lignocaine 4 ml and dexmedetomidine 1.5 μg/kg.
The mean cough score was (1.17 ± 0.37), (1.40 ± 0.49), and (1.70 ± 0.75) in group III, group II, and group I, respectively. A significant difference was found between the groups. Patients were more comfortable with a statistically significant difference in the comfort score in group III as compared to group II and group I.
Dexmedetomidine nebulization in a dose of 1.5 μg/kg (compared to 1 μg/kg or 0.5 μg/kg) as an adjuvant to lignocaine, provides better bronchoscopy conditions and patient satisfaction.
支气管镜检查期间的轻至中度镇静对于患者安全、检查过程中和检查后的舒适度以及便于支气管镜检查医生操作至关重要。右美托咪定是一种高度选择性的中枢性α-2激动剂,用于在各种操作过程中提供清醒镇静。本研究的目的是比较三种不同剂量的右美托咪定雾化作为支气管镜检查期间利多卡因辅助剂的疗效。
招募了90例年龄在18至60岁之间、美国麻醉医师协会身体状况分级为I/II级、计划进行择期支气管镜检查的患者。他们被分为三组,每组30例。第一组:患者用4毫升4%利多卡因和0.5微克/千克右美托咪定的混合物进行雾化。第二组:患者用4%利多卡因4毫升和1微克/千克右美托咪定的混合物进行雾化。第三组:患者用4%利多卡因4毫升和1.5微克/千克右美托咪定进行雾化。
第三组、第二组和第一组的平均咳嗽评分别分为(1.17±0.37)、(1.40±0.49)和(1.70±0.75)。各组之间存在显著差异。与第二组和第一组相比,第三组患者的舒适度更高,舒适度评分存在统计学显著差异。
作为利多卡因的辅助剂,1.5微克/千克剂量的右美托咪定雾化(与1微克/千克或0.5微克/千克相比)可提供更好的支气管镜检查条件和患者满意度。