[Application of bispectral index monitoring in sedation and analgesia for flexible bronchoscopy].

Objective

To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy.

Methods

Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years). The 2 groups were compared in terms of operation time, blood pressure, heart rate and other indicators during bronchoscopy including incidence of adverse events, memory of the procedure, willingness to be re-examined, safety of sedation and analgesia for bronchoscopy under bispectral index monitoring, and patient satisfaction in the postoperative follow-up.

Results

The conscious sedation group and the control group had no difference in age and sex ratio(P>0.05). Compared with the patients in the control group(operation time 16±5 min and systolic blood pressure 153±21 mmHg, 1 mmHg=0.133 kPa), those in the conscious sedation group had a shorter operation time(14±5 min) and a lower systolic blood pressure(144±22 mmHg), with statistically significant difference (P<0.01). There was no significant difference in diastolic blood pressure and heart rate (89±14 mmHg and 84±17 times/min in the conscious sedation group and 92±12 mmHg and 87±14 times/min in the control group, P>0.05). Adverse events, overall intraoperative cough and bleeding were found to be significantly reduced in the conscious sedation group (27%, 4% and 13% and 60%, 13% and 35% in the control group, P<0.01), but transient hypoxia was not (12% in the conscious sedation group, and 14% in the control group, P=0.72). Patient satisfaction and willingness to be re-examined were markedly higher in the conscious sedation group (97%) than in the controls (4%, P<0.01).

Conclusions

Bispectral index monitoring is safe in sedation and analgesia for bronchoscopy and has higher patient satisfaction, suggesting that it is a potential tool for use in clinical practice.