Chang Ya-Chi, Lee Kun-Ta, Chen Ching-Yi, Liu I-Jung, Yeh Yun-Kai, Chen Kuan-Yuan, Feng Po-Hao, Tsai Cheng-Yu
Respiratory Therapy Room, Division of Pulmonary Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan.
Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
Healthcare (Basel). 2025 Sep 4;13(17):2218. doi: 10.3390/healthcare13172218.
: While a combination of the Target-Controlled Infusion (TCI) system and Bispectral Index (BIS) monitoring has emerged as an effective approach for sedation management during bronchoscopy, its benefits and potential risks remain insufficiently explored. In this study, we evaluated the impacts of the BIS- and TCI-guided sedation systems on patient comfort and procedural workflow during bronchoscopy. : A prospective observational study was conducted at a single tertiary medical center. Patients scheduled for diagnostic bronchoscopy were assigned to either a sedation group or a control group, and the sedation group received BIS- and TCI-guided sedation using propofol and fentanyl. Objective time metrics such as the procedure time, observation time, and overall total time were recorded. Subjective outcomes including pain, discomfort, and fear levels were assessed using a visual analogue scale (range: 0-10). Operator-rated procedural difficulty was also assessed. : The use of a BIS- and TCI-guided sedation system did not significantly affect the procedure duration but led to prolonged observation and overall total times. Patients in the sedation group reported significantly lower pain, coughing, and breathlessness sensations and overall discomfort levels compared to the control group. Both pre- and post-procedural fear levels were lower in the sedation group. Operator-rated procedural difficulty was significantly lower in the sedation group, and operator-reported difficulty was significantly correlated with both endoscopic insertion and coughing sensations. : These findings support that the BIS- and TCI-guided sedation system may improve patient experiences and optimize procedural workflow during bronchoscopy. Future randomized studies with larger and more-diverse populations are recommended to enhance the robustness and generalizability of the results.
虽然靶控输注（TCI）系统与脑电双频指数（BIS）监测相结合已成为支气管镜检查期间镇静管理的有效方法，但其益处和潜在风险仍未得到充分探索。在本研究中，我们评估了BIS和TCI引导的镇静系统对支气管镜检查期间患者舒适度和操作流程的影响。
在一家单一的三级医疗中心进行了一项前瞻性观察性研究。计划进行诊断性支气管镜检查的患者被分配到镇静组或对照组，镇静组使用丙泊酚和芬太尼接受BIS和TCI引导的镇静。记录了诸如操作时间、观察时间和总时间等客观时间指标。使用视觉模拟量表（范围：0-10）评估包括疼痛、不适和恐惧程度在内的主观结果。还评估了操作者评定的操作难度。
使用BIS和TCI引导的镇静系统对操作持续时间没有显著影响，但导致观察时间和总时间延长。与对照组相比，镇静组患者报告的疼痛、咳嗽和呼吸困难感觉以及总体不适水平显著更低。镇静组术前和术后的恐惧程度均较低。镇静组操作者评定的操作难度显著更低，并且操作者报告的难度与内镜插入和咳嗽感觉均显著相关。
这些发现支持BIS和TCI引导的镇静系统可能会改善支气管镜检查期间患者的体验并优化操作流程。建议未来进行更大规模、更多样化人群的随机研究，以增强结果的稳健性和普遍性。
