Sedation with midazolam in flexible bronchoscopy - a prospective study [Sedação com midazolam na broncofibroscopia - estudo prospetivo]

Introduction: sedatives have been increasingly used to improve patient comfort during flexible bronchoscopy (fob). due to its rapid-onset,anxiolytic and amnestic properties,midazolam is one of the most commonly used sedatives. objectives: to evaluate the effect of sedation with midazolam,including patient tolerance,complications and its potential use on a daily routine basis. material and methods: a multi-centre,prospective,randomized,placebo-controlled study was made on 100 patients submitted to fob in two pulmonology departments. midazolam (0.05. mg/kg) was administered to patients in group 1 and saline solution (0,9% nacl) to patients in group 2,five minutes before the procedure. the hospital anxiety and depression scale (hads-a) was used to determine patient anxiety level. subjective questionnaires concerning main fears and complaints were answered before and after fob. results: mean age was 56.0 ± 14.1 years; 66% male. most (65%) patients had low score (<7) in hads-a scale with no difference between groups. no significant differences were seen between groups concerning fob duration,procedures,lidocaine dosage and complications. systolic blood pressure during and after fob was significantly higher (p<0.003) in group 2. patients in group 1 experienced less cough (32% vs 56%; p=0.03) and dyspnea (2% vs 34%; p<0.001) than in group 2,while nausea (6% vs 18%; p>0.05) and pain (4% vs 12%; p>0.05) were not statistically different. willingness to repeat the exam was reported in all patients in group 1 and in 82% in group 2 (p=0.003). conclusion: sedation with midazolam in fob improved patient's comfort and decreased complaints,without significant haemodynamic changes. it should be offered to the patient on a routine basis. © 2011 sociedade portuguesa de pneumologia.