Efficacy And Safety Of Low Dose Midazolam Combined With Dexmedetomidine For Flexible Bronchofiberscope Examination In Elderly People

Objective To estimate the efficacy and safety of low dose Midazolam combined with Dexmedetomidine(DEX) for flexible bronchofiberscope examination in elderly people.Methods A total of120patients aged between65-75and weight between50-75kg, ASA I-II were included in this trial. The subjects were randomly devided into five groups:group DEX1-4and group M(control). All patients injected with Midazolam0.02mg/kg slowly and pharyngeal portion permeation analgesia with tetracaine before the examination. Patients in DEX groups were injected with a loading dose1.Omg/kg of DEX10minutes before examination, and then infused at a rate of0.2、0.4、0.6、0.8ug.kg-l.h-1respectively until the end of the examination. If severe cough appeared during the examination2%lidocaine2ml was injected. MAP、HR、 SpO2、OAA/s scores of baseline(TO), immediate after anesthesia induction (Tl), immediate after bronchofiberscope entered glottis (T2),immediate after bronchofiberscope reached carina(T3), after examination(T4) and10minutes after examination (T5) were recorded. The intubation time, side effects during examination and lidocaine dose added were also recorded.Results Compared with T0, T1-T4OAA/s scores of group DEX1-4significantly reduced. T1MAP scores of group DEX1-4were slightly higher than TO while T2> T3MAP and HR scores of group M was significantly higher. T3, T4OAA/s scores of group DEX4significantly deduced compared with other4groups.Conclusion Loading dose of DEX was lug/kg when using low dose Midazolam combined with Dexmedetomidine for flexible bronchofiberscope examination in elderly people.0.4-0.6ug.kg-1.h-1was the right maintenance dose for the smallist effct on respiratory and circulatory systerm and best patient cooperation.