The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial

Sedation is recommended by most guidelines to be offered to all patients undergoing diagnostic flexible bronchoscopy (DFB) without contraindications, and the most commonly reported regimen is midazolam in combination with a short-acting opioid (fentanyl or alfentanil) to provide both sedative and an...

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Main Authors: Longfei Wang, Qiuyue Wu, Ming Wang, Wanquan Ming, Cheng Sheng, Yonghua Zhang, Yongbin Chen, Yunfei Cao
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-10-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2022.1036840/full
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author Longfei Wang
Qiuyue Wu
Ming Wang
Wanquan Ming
Cheng Sheng
Yonghua Zhang
Yongbin Chen
Yunfei Cao
author_facet Longfei Wang
Qiuyue Wu
Ming Wang
Wanquan Ming
Cheng Sheng
Yonghua Zhang
Yongbin Chen
Yunfei Cao
author_sort Longfei Wang
collection DOAJ
description Sedation is recommended by most guidelines to be offered to all patients undergoing diagnostic flexible bronchoscopy (DFB) without contraindications, and the most commonly reported regimen is midazolam in combination with a short-acting opioid (fentanyl or alfentanil) to provide both sedative and antitussive effects. However, the optimal dose or ideal regimen of the combination therapy with midazolam and opioids has not yet been found. So this randomized, double-blinded clinical trial was designed and registered (ChiCTR2100049052) to assess the safety and efficacy of midazolam combined with different doses of alfentanil in DFB sedation. Our study showed that relative high doses of alfentanil (10–25 μg/kg) combined with a fixed low dose of midazolam can markedly reduce hemodynamic fluctuations, cough reactions, patients’ discomforts, and improve their satisfaction in a dose-dependent manner during DFB, with no significant increase in the desaturation risks.
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spelling doaj.art-cbefa07898394b3ca1ab4215c17e39912022-12-22T03:25:54ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-10-011310.3389/fphar.2022.10368401036840The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trialLongfei Wang0Qiuyue Wu1Ming Wang2Wanquan Ming3Cheng Sheng4Yonghua Zhang5Yongbin Chen6Yunfei Cao7School of Medicine, Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaSchool of Medicine, Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, Beilun District People’s Hospital of Ningbo, Ningbo, ChinaDepartment of Anesthesiology, Beilun District People’s Hospital of Ningbo, Ningbo, ChinaDepartment of Pulmonary, Beilun District People’s Hospital of Ningbo, Ningbo, ChinaDepartment of Pulmonary, Beilun District People’s Hospital of Ningbo, Ningbo, ChinaDepartment of Anesthesiology, Beilun District People’s Hospital of Ningbo, Ningbo, ChinaSedation is recommended by most guidelines to be offered to all patients undergoing diagnostic flexible bronchoscopy (DFB) without contraindications, and the most commonly reported regimen is midazolam in combination with a short-acting opioid (fentanyl or alfentanil) to provide both sedative and antitussive effects. However, the optimal dose or ideal regimen of the combination therapy with midazolam and opioids has not yet been found. So this randomized, double-blinded clinical trial was designed and registered (ChiCTR2100049052) to assess the safety and efficacy of midazolam combined with different doses of alfentanil in DFB sedation. Our study showed that relative high doses of alfentanil (10–25 μg/kg) combined with a fixed low dose of midazolam can markedly reduce hemodynamic fluctuations, cough reactions, patients’ discomforts, and improve their satisfaction in a dose-dependent manner during DFB, with no significant increase in the desaturation risks.https://www.frontiersin.org/articles/10.3389/fphar.2022.1036840/fullFiberoptic bronchoscopySedationAlfentanilMidazolamFentanylSafety
spellingShingle Longfei Wang
Qiuyue Wu
Ming Wang
Wanquan Ming
Cheng Sheng
Yonghua Zhang
Yongbin Chen
Yunfei Cao
The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
Frontiers in Pharmacology
Fiberoptic bronchoscopy
Sedation
Alfentanil
Midazolam
Fentanyl
Safety
title The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
title_full The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
title_fullStr The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
title_full_unstemmed The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
title_short The safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation: A randomized, double-blind, controlled trial
title_sort safety and efficacy of alfentanil combined with midazolam in fiberoptic bronchoscopy sedation a randomized double blind controlled trial
topic Fiberoptic bronchoscopy
Sedation
Alfentanil
Midazolam
Fentanyl
Safety
url https://www.frontiersin.org/articles/10.3389/fphar.2022.1036840/full
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