Does sedation help in fibreoptic bronchoscopy?

Abstract

Although sedation is associated with major complications1,2 sedative drugs are often given immediately before fibreoptic bronchoscopy in the belief that patients' comfort is improved. Uncontrolled studies have shown that fibreoptic bronchoscopy is well tolerated without sedation.3,4 Most comparative studies of premedication have looked at different drug regimens; we are aware of only one study that included an unsedated control arm.5 Opiates and benzodiazepines are frequently used for sedation during fibreoptic bronchoscopy; we compared two such regimens with placebo. Of 184 patients undergoing routine diagnostic fibreoptic bronchoscopy without transbronchial biopsy, 182 consented to enter a consecutive double blind comparison of (a) intravenous phenoperidine and droperidol with saline placebo or (b) intravenous midazolam with saline placebo. Three doctors performed the bronchoscopy; all patients received supplemental oxygen, topical lignocaine, intravenous atropine 600 μg, and the …