Hassan Kazmi Syed Murtaza, Abbasi Mahnoor Nawaz, Mudassir Yusra, Chaudhary Rashiqua Sulman, Siddiqa Ayesha, Atiq Muslim, Jafry Syed Shah Hussain, Ilyas Anum
Pulmonology, Shifa International Hospital Islamabad, Islamabad, PAK.
General Medicine, Shifa International Hospital Islamabad, Islamabad, PAK.
Cureus. 2024 Jun 14;16(6):e62381. doi: 10.7759/cureus.62381. eCollection 2024 Jun.
Flexible bronchoscopy (FB) often involves sedation, with the choice left to the bronchoscopist's discretion. Prior research on sedation in gastroscopic endoscopies yields conflicting information regarding the preferred method for FB. This study compares patient comfort levels during bronchoscopy with mindful sedation using fentanyl, nalbuphine, and midazolam versus monitored anesthesia care (MAC) using propofol, midazolam, and ketamine.
This prospective observational study assessed 83 patients undergoing bronchoscopy under either conscious sedation (CS) (n=40) or MAC (n=43). Patient comfort, sedation levels, emotional state, recovery time, safety, and the impact of smoking history and comorbidities were evaluated. Data collection included direct patient questioning and observation using the Modified Observed Assessment of Alertness and Sedation (MOAA/S) form.
Comfort levels were similar between groups, with mean scores of 3.6±0.89 for CS and 3.3±0.54 for MAC. MAC induced deeper sedation (mean scores: 4.37±0.66 vs. 3.8±0.98). Recovery time and complications were comparable. Emotional states and medical history did not significantly differ between groups.
CS is not inferior to MAC for bronchoscopy, providing comparable comfort and safety with less intense sedation and lower cost. These findings support the use of CS for bronchoscopy procedures, offering a cost-effective alternative without compromising patient comfort or safety.
可弯曲支气管镜检查（FB）通常需要镇静，具体选择由支气管镜检查医师自行决定。先前关于胃镜检查镇静的研究，对于FB的首选方法给出了相互矛盾的信息。本研究比较了在支气管镜检查期间，使用芬太尼、纳布啡和咪达唑仑进行正念镇静与使用丙泊酚、咪达唑仑和氯胺酮进行监护麻醉（MAC）时患者的舒适度。
这项前瞻性观察性研究评估了83例接受清醒镇静（CS）（n = 40）或MAC（n = 43）下支气管镜检查的患者。评估了患者的舒适度、镇静水平、情绪状态、恢复时间、安全性，以及吸烟史和合并症的影响。数据收集包括直接询问患者和使用改良的警觉与镇静观察评估量表（MOAA/S）进行观察。
两组的舒适度相似，CS组的平均评分为3.6±0.89，MAC组为3.3±0.54。MAC诱导的镇静更深（平均评分：4.37±0.66对3.8±0.98）。恢复时间和并发症相当。两组之间的情绪状态和病史没有显著差异。
在支气管镜检查中，CS并不逊色于MAC，在提供相当的舒适度和安全性的同时，镇静程度较轻且成本较低。这些发现支持在支气管镜检查程序中使用CS，提供了一种经济有效的替代方案，而不影响患者的舒适度或安全性。
