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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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.1036840/full |
| _version_ | 1828219022541324288 |
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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. |
| first_indexed | 2024-04-12T16:11:15Z |
| format | Article |
| id | doaj.art-cbefa07898394b3ca1ab4215c17e3991 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T16:11:15Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| 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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