Comparison of safety and efficacy of dexmedetomidine, midazolam and propofol for elective fiberoptic bronchoscopy: A randomised prospective double blind study

Abstract

Background: Sedatives are used to improve the efficacy of fiberoptic bronchoscopy. This study was conducted to evaluate and compare the safety and efficacy of dexmedetomidine, midazolam, and propofol for elective fiberoptic bronchoscopy. Materials and Methods: One hundred and twenty patients of either gender aged between 18 and 80 years, belonging to the American Society of Anesthesiologists Grade I–III and requiring fiberoptic bronchoscopy, were randomly assigned in three groups of 40 patients each. Patients in Group D received intravenous dexmedetomidine 1 μg/kg; in Group M, received IV midazolam 0.05 mg/kg; and in Group P, received IV propofol 1.5 mg/kg before the start of bronchoscopy. Parameters such as composite score, ease of bronchoscopy, and adverse effects during the procedure were assessed and analyzed statistically. Results: Patients receiving dexmedetomidine showed significantly better tolerance and cooperation with ideal mean composite score compared to those receiving propofol and midazolam (P < 0.001). Bronchoscopist scoring showed significantly better ease of bronchoscopy in patients receiving dexmedetomidine compared to other two groups (P < 0.001). Adverse effects during the procedure were least in dexmedetomidine group compared to other two groups. Conclusion: Dexmedetomidine (1 μg/kg) provided a better sedation and comfort, better bronchoscopist satisfaction, and least adverse effect during elective fiberoptic bronchoscopy compared to midazolam (0.05 mg/kg) and propofol (1.5 mg/kg).