Effectiveness of nebulized dexmedetomidine as a premedication in flexible bronchoscopy in Indian patients -a prospective, randomized, double blinded study

DOI: https://doi.org/10.21203/rs.3.rs-1448717/v1

Abstract

Background: Studies have proven the efficacy of intravenous dexmedetomidine in patient comfort during flexible bronchoscopy without causing any respiratory depression. Intravenous administration of sedative agents requires expertise and presence of an anaesthetist. This adds to the cost of the bronchoscopy. Inhalational administration of sedative agents can improve the safety profile due to its local action, with similar efficacy. There are only limited studies which have looked at the effects of nebulized dexmedetomidine in bronchoscopy. Dexmedetomidine in nebulized form is an easy non-invasive method of sedation, in situations where manpower is not trained in intravenous sedation. It alleviates the need of an anesthetist, Shortens the duration of the procedure and hospital stay and thus reduces the overall procedural cost to the patient, without any adverse events

Methods: The study is prospective, randomized, double blinded. Patients who requires bronchoscopy and is meeting the inclusion criteria is randomized to receive either dexmedetomidine nebulization or saline (0.9%) nebulization after recording the baseline vital parameters. The study parameters are assessed and recorded using a proforma. Patients are assessed both objectively and subjectively using a proforma at specific time periods. Data collected is analyzed using SPSS software

Discussion: Commonly used agents for sedation in bronchoscopy including midazolam, fentanyl and dexmedetomidine. However, side effects with intravenous sedative agents like respiratory depression and bradycardia are seen. Dexmedetomidine, a relatively newer drug is proven to be effective agent for sedation compared to the other standard agents used. However nebulized form of dexmedetomidine, being locally acting is comparatively safer with lesser incidence of hemodynamic instability while being as effective as the intravenous form. Trial registration: The study is submitted for registration with the Central Trial Registry – India 

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