Midazolam With or Without Pethidine During Bronchoscopy

According to Masahiro Katsurada and colleagues, few studies have evaluated the combination of sedatives and opioids in patients undergoing bronchoscopy. They conducted a randomized trial on midazolam with or without pethidine in patients undergoing bronchoscopy and found that “the combination uses of midazolam and pethidine for sedation resulted in significant improvements in the pain, blood pressure, additional use of midazolam, and safety during bronchoscopy among patients,” according to their article in BMC Cancer.

The study included 100 patients who were scheduled to undergo bronchoscopy biopsy. After the procedure, the patients completed a questionnaire. The primary endpoint of the study was the “patients’ acceptance of re-examination assessed by visual analogue scale.” Additional measures in the study included pain, vital signs, midazolam use, xylocaine use, and adverse events. The final analysis included 47 patients in the midazolam and pethidine combination group and 49 patients in the midazolam only group.

Bronchoscopy Sedation Results

In the article, the researchers reported that “the primary outcome was a good trend in the combination group, but not significantly different (3.82 ± 2.3 in combination group versus 4.17 ± 2.75 in midazolam alone; p = 0.400). Notably, the visual analog scores for pain levels during bronchoscopy were significantly lower in the combination group compared to the midazolam group (p = 0.022), and the combination group’s sedation level was “significantly deeper” (p = 0.031). In addition, both additional midazolam use, maximal systolic blood pressure during testing, and adverse events were significantly lower for patients in the combination group.

In summary, the investigators proposed that “the combination of midazolam and pethidine attenuated pain and showed significant improvements in objective indicators such as vital signs and adverse events” in patients undergoing sedation for bronchoscopy.”

Browse more hematology and oncology expert articles and videos