Application Of Small Dose Midazolam Intravenous Infusion Combined With Sufentanil In Bronchoscopy

Objective: The purpose of this study was to investigate the efficacy and safety of lowdose midazolam intravenous infusion combined with sufentanil in bronchoscopy,and to evaluate its effect on patients,tolerance and satisfaction.Methods: Collect data on 90 hospitalized patients who underwent bronchoscopy due to pulmonary diseases at the Department of Respiratory Medicine,Yijishan Hospital of Wannan Medical College from September 2018 to March 2020,including 30 in intravenous pump group,30 in intravenous injection group and 30 in control group.In intravenous pump group,on the basis of 2% lidocaine spray local surface anesthesia,midazolam(1mg)and sufentanil(5ug)was injected intravenously 5 minutes before bronchoscopy.And continued to pump midazolam intravenously during operation(1mg/h).Patients in intravenous injection group also received 2% lidocaine surface anesthesia at first,they began to receive intravenous injection of midazolam(2mg)and sufentanil(5ug)5 minutes before bronchoscopy.And then added midazolam as appropriate during operation(1-2mg).The control group only received local surface topical anesthesia with 2% lidocaine before operation.Before bronchoscopy,each patient of the three groups had signed an informed consent.Monitor the heart rate,respiratory rate,blood pressure oxygen saturation and other vital signs before,during and after bronchoscopy.Calculate the fluctuation value(which from the maximum value subtract the minimu value)of each index separately.Evaluate the effects during anesthesia according to the bronchoscopy score and the vigilance/sedation score.Observe and record the adverse reactions of patients during the bronchoscopy.After bronchoscopy,conduct a questionnaire survey on patients,satisfaction with operation.Results: There were no obvious differences amoung the three groups in the general condition,such as age,weight,gender,previous medical history,operation items,etc(P>0.05).While there were significant differences in the bronchoscopy examination score and OAA/S score amoung the three groups(P<0.05).The bronchoscopy score of intravenous pump group was lower than that of intravenous injection group and control group(P<0.05).As for the OAA/S score,there was the similar situation,which suggests that the approach to anesthesia of the the intravenous pump group is more effective.Analysize the vital signs of the three groups,we found that the vital signs indicators were similar in each groups before the inspection(P>0.05).The change of systolic blood pressure and diastolic blood pressure in the intravenous pump group was both lower than that in the intravenous injection group and control group(P<0.05).Meantime,the fluctuations of the heart rate,respiratory frequency and blood oxygen saturation of intravenous pump group were both smaller than that of intravenous injection group and control group(P<0.05).In the intravenous pump group and the intravenous injection group,the incidence of adverse reactions such as body movement,coughing,and suffocation was lower than that of the control group(P<0.05),but the incidence of adverse reactions such as dizziness and lethargy was higher(P<0.05).In terms of postoperative satisfaction,the intravenous pump group had the highest satisfaction,the control group had the lowest satisfaction.Meantime,most of the patients in the control group were unwilling to accept bronchoscopy again.Conclusion: Low dose midazolam intravenous infusion combined with sufentanil in bronchoscopy is safe and effective,which can effectively alleviate patients’ discomfort,improve their tolerance and coordination,and is recommended to promote the application in clinical.