Feasibility and safety of propofol sedation in flexible bronchoscopy

Abstract

BACKGROUND: Propofol is a sedative-hypnotic with a rapid onset of action. There are only limited data evaluating propofol for flexible bronchoscopy. We analysed the feasibility and safety of propofol for bronchoscopy in a high output tertiary care centre. METHODS: Prospective data on patients undergoing flexible bronchoscopy at the University Hospital Basel, Switzerland, were analysed. Patient demographics, ASA class, Mallampati class, indication for bronchoscopy, bronchoscopic procedures, duration of examination, medication requirements, minor and major adverse events, haemodynamic parameters, as well as cough scores during the procedure were documented. Patients were followed up to discharge from the bronchoscopy suite. RESULTS: Data from 440 patients with a mean age 60 years (±15.5, 260 male) were analysed. The main indication for bronchoscopy was a suspicion of malignancy. The most common diagnostic procedures were bronchoalveolar lavage in 253 cases (31.5%) and bronchial washing in 174 cases (21.7%). The mean duration of the procedure was 19.6 min (±12.08). The mean propofol dose was 200 mg (±107.5) corresponding to 2.89 mg/kg (±1.70). Minor adverse events included oxygen desaturation in 72 (16.4%), hypotension in 68 (15.4%) and minor bleeding in 11 (2.5%) patients. No major adverse events were recorded. The median decline in systolic blood pressure after initiation of sedation was 14 mm Hg (3–28). A drop in systolic blood pressure greater than 20 mm Hg was observed in 166 of the 440 patients (37%). CONCLUSION: Propofol sedation for flexible bronchoscopy is feasible and safe.

Keywords

• endoscopy
• medication
• procedure
• respiratory
• Risk