Abstract
Introduction: Although pleuroscopy is a safe procedure with a low complication rate it still requires the use of procedural sedation and analgesia.
Objectives: This prospective study evaluated the effects of dexmedetomidine administration on oxygenation and respiratory function in patients undergoing diagnostic or therapeutic pleuroscopy.
Materials and Methods: 55 enrolled patients received either a dexmedetomidine infusion or conventional (midazolam/fentanyl) sedation. Arterial blood gas and spirometry measurements were obtained at baseline and at predetermined endpoints. Drug consumption, time to recover from sedation, perioperative pain and adverse events were also recorded.
Results: A lesser postoperative decrease in FEV1 in the dexmedetomidine group [mean (95%CI): 2 (-13-16) vs. 20 (11-29), p=0.039] was observed. Additionally, a significant reduction in midazolam (1.4±1mg vs 4±1.3mg, p<0.001) and fentanyl consumption (87±45μg vs 218±77μg, p<0.001) was demonstrated, with a more rapid recovery post procedure [mean (95%CI): 9.5min (7.2-11) vs 17.8min (12.7-22.8)]. During the perioperative period, patients receiving dexmedetomidine also reported lower pain scores [mean (95%CI): 1 (0.33-1.67) vs 2.54 (1.5-3.6), p=0.02].
Conclusions: This study demonstrated that dexmedetomidine use provides a lower decrease in FEV1 after pleuroscopy, reduces significantly the consumption of other sedatives and analgesics and accelerates postoperative awakening. Therefore dexmedetomidine can constitute a valuable alternative sedation agent in patients undergoing pleuroscopy, given its superior pharmacokinetic and pharmacodynamic profile.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3790.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021