%0 Journal Article %A Moussa Riachy %A Georges Khayat %A Ihab Ibrahim %A Zeina Aoun-Bacha %A Georges Dabar %A Taha Bazarbachi %A Nadine Khalil %A Bassem Habr %T Sedation regimens comparison during flexible bronchoscopy: Dexmedetomidine, alfentanil and lidocaine %D 2015 %R 10.1183/13993003.congress-2015.PA321 %J European Respiratory Journal %P PA321 %V 46 %N suppl 59 %X Background: Bronchoscopy tolerance varies significantly between patients, and no standardized protocol for sedation during bronchoscopy is currently available.Aims and Objectives: This study aimed at evaluating the efficacy and safety of three regimens: Dexmedetomidine (D) or Alfentanil (A) combined with local anesthesia, and local anesthesia alone (C).Methods: This randomized double-blind controlled trial included 162 patients undergoing bronchoscopy. Patients received 15 ml of lidocaine 1% alone (C) or combined with dexmedetomidine 0.5 mcg/kg (D) or alfentanil 10 mcg/kg (A). Lidocaine and midazolam were added as needed. Tolerance was assessed using the bronchoscopy score (BS), and level of sedation was assessed using the Nursing Instrument for the Communication of Sedation (NICS). Safety was evaluated in terms of pulmonary function and vital signs.Results: BS were identical in all groups. Group D subjects were the most sedated (p 0.013) whereas group A subjects were the least agitated. Linear regression showed a negative association between BS and age in A (β=-0.07, p 0.003). Male gender (β=2.47, p 0.001) and longer procedure (β=-0.12, p 0.010), and obesity (β=-2.23, p 0.026) and shorter procedure (β=0.08, p 0.020) were positive predictors of BS in D C respectively. Desaturation was most prevalent in A compared to D and C respectively (p 0.006). Hypotension was mostly observed in D.Conclusion: Though there were no consistent differences in efficacy and safety between the three regimens, results suggest that dexmedetomidine would be a better option in males and longer procedures, alfentanyl in elderly and lidocaine alone in obese patients and shorter procedures. NCT02301923. %U