Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: A randomized controlled trial

Yu Lun Lo, Ting Yu Lin, Yueh Fu Fang, Tsai Yu Wang, Hao Cheng Chen, Chun Liang Chou, Fu Tsai Chung, Chih Hsi Kuo, Po Hao Feng, Chien Ying Liu, Han Pin Kuo

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Abstract

Objectives: There are safety issues associated with propofol use for flexible bronchoscopy (FB). The bispectral index (BIS) correlates well with the level of consciousness. The aim of this study was to show that BIS-guided propofol infusion is safe and may provide better sedation, benefiting the patients and bronchoscopists. Methods: After administering alfentanil bolus, 500 patients were randomized to either propofol infusion titrated to a BIS level of 65-75 (study group) or incremental midazolam bolus based on clinical judgment to achieve moderate sedation. The primary endpoint was safety, while the secondary endpoints were recovery time, patient tolerance, and cooperation. Results: The proportion of patients with hypoxemia or hypotensive events were not different in the 2 groups (study vs. control groups: 39.9% vs. 35.7%, p = 0.340; 7.4% vs. 4.4%, p = 0.159, respectively). The mean lowest blood pressure was lower in the study group. Logistic regression revealed male gender, higher American Society of Anesthesiologists physical status, and electrocautery were associated with hypoxemia, whereas lower propofol dose for induction was associated with hypotension in the study group. The study group had better global tolerance (p

Original languageEnglish
Article numbere27769
JournalPLoS One
Volume6
Issue number11
DOIs
Publication statusPublished - Nov 23 2011
Externally publishedYes

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ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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