Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy
Abstract Background Bronchoscopy is sometimes stressful in cases where there may be anxiety related to discomfort, breathing problems, or other potential complications. Various sedatives, such as benzodiazepines, opioids, and dexmedetomidine, have been utilized. The objective of this work is to stud...
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SpringerOpen
2025-03-01
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| Series: | The Egyptian Journal of Bronchology |
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| Online Access: | https://doi.org/10.1186/s43168-025-00385-3 |
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| author | Wael Emam Marwa Hussein |
| author_facet | Wael Emam Marwa Hussein |
| author_sort | Wael Emam |
| collection | DOAJ |
| description | Abstract Background Bronchoscopy is sometimes stressful in cases where there may be anxiety related to discomfort, breathing problems, or other potential complications. Various sedatives, such as benzodiazepines, opioids, and dexmedetomidine, have been utilized. The objective of this work is to study and compare the safety and efficacy of flexible Bronchoscopy sedation using incremental midazolam versus combined midazolam/fentanyl. Methods A prospective study was done on 60 cases from March 2023 to February 2024. Eligible patients are randomized to two groups: either sedation with midazolam or midazolam combined with fentanyl. Vital parameters like pulse rate, non-invasive blood pressure, and SpO2 levels were recorded before beginning the procedure, again at the fifth and fifteenth minute during the procedure, and 10 min after completion of the procedure. Patient-reported tolerance, satisfaction, and physician-reported feasibility of the procedure were assessed using a post-bronchoscopy questionnaire. Results Ninety percent of cases in the midazolam group (group A) and 73% of cases in the fentanyl and midazolam group (group B) were satisfied with the procedure. In both groups, the majority of patients were not bothered by local anesthesia or by bronchoscope insertion or its passage through the vocal cords. Breathing difficulty, cough, or pain during the procedure were evenly endured. Twenty-one patients in both groups reported willing to repeat the procedure in the future. Adding Fentanyl to midazolam showed no significant improvement. Conclusion Bronchoscopy is generally a safe procedure with a low risk of serious complications. The addition of conscious sedation to bronchoscopy made the procedure satisfactory. Patient satisfaction and procedural tolerability were equal in both midazolam and midazolam-fentanyl. |
| format | Article |
| id | doaj-art-71fbf012e2044d24802b6153af1745fb |
| institution | OA Journals |
| issn | 2314-8551 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Bronchology |
| spelling | doaj-art-71fbf012e2044d24802b6153af1745fb2025-08-20T02:10:12ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-03-011911810.1186/s43168-025-00385-3Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopyWael Emam0Marwa Hussein1Department of Chest Diseases, Faculty of Medicine, Ain Shams UniversityDepartment of Chest Diseases, Faculty of Medicine, Ain Shams UniversityAbstract Background Bronchoscopy is sometimes stressful in cases where there may be anxiety related to discomfort, breathing problems, or other potential complications. Various sedatives, such as benzodiazepines, opioids, and dexmedetomidine, have been utilized. The objective of this work is to study and compare the safety and efficacy of flexible Bronchoscopy sedation using incremental midazolam versus combined midazolam/fentanyl. Methods A prospective study was done on 60 cases from March 2023 to February 2024. Eligible patients are randomized to two groups: either sedation with midazolam or midazolam combined with fentanyl. Vital parameters like pulse rate, non-invasive blood pressure, and SpO2 levels were recorded before beginning the procedure, again at the fifth and fifteenth minute during the procedure, and 10 min after completion of the procedure. Patient-reported tolerance, satisfaction, and physician-reported feasibility of the procedure were assessed using a post-bronchoscopy questionnaire. Results Ninety percent of cases in the midazolam group (group A) and 73% of cases in the fentanyl and midazolam group (group B) were satisfied with the procedure. In both groups, the majority of patients were not bothered by local anesthesia or by bronchoscope insertion or its passage through the vocal cords. Breathing difficulty, cough, or pain during the procedure were evenly endured. Twenty-one patients in both groups reported willing to repeat the procedure in the future. Adding Fentanyl to midazolam showed no significant improvement. Conclusion Bronchoscopy is generally a safe procedure with a low risk of serious complications. The addition of conscious sedation to bronchoscopy made the procedure satisfactory. Patient satisfaction and procedural tolerability were equal in both midazolam and midazolam-fentanyl.https://doi.org/10.1186/s43168-025-00385-3BronchoscopyConscious sedationFentanylMidazolam |
| spellingShingle | Wael Emam Marwa Hussein Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy The Egyptian Journal of Bronchology Bronchoscopy Conscious sedation Fentanyl Midazolam |
| title | Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| title_full | Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| title_fullStr | Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| title_full_unstemmed | Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| title_short | Safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| title_sort | safety and efficacy of using a combination of midazolam and fentanyl in comparison to midazolam only during flexible bronchoscopy |
| topic | Bronchoscopy Conscious sedation Fentanyl Midazolam |
| url | https://doi.org/10.1186/s43168-025-00385-3 |
| work_keys_str_mv | AT waelemam safetyandefficacyofusingacombinationofmidazolamandfentanylincomparisontomidazolamonlyduringflexiblebronchoscopy AT marwahussein safetyandefficacyofusingacombinationofmidazolamandfentanylincomparisontomidazolamonlyduringflexiblebronchoscopy |