Methods
dysfunction of liver, kidney and other organ,, tumor, pneumonia, abnormal coagulation, hypoxia, allergy, tuberculosis, cough, hemoptysis
ABNORMAL COAGULATION, TUMOR, PNEUMONIA, HYPOXIA, RESPIRATORY INSUFFICIENCY, ALLERGY, TUBERCULOSIS
This is a prospective, randomized, double-blind trial comparing the safety and comfort in patients undergoing fiberoptic bronchoscopy with propofol/remifentanil versus propofol/ketamine. A total of 90 adult patients (aged 18–65 years; ASA grade I or II), who underwent selective fiberoptic bronchoscopy, were recruited in the study. Patients were randomly allocated into two groups with the random number table, with a 1:1 ratio and 42 cases in each group. Indications included diagnostic tests for tuberculosis (33%), tumor inspection (26%), pneumonia (25%), chronic cough (10%), and hemoptysis (6%). The exclusion criteria were dysfunction of liver, kidney and other organ, abnormal coagulation function, mental illness, severe respiratory insufficiency, and history of severe allergy to the test drugs. All included patients and the bronchoscopists who performs fiberoptic bronchoscopy were blinded to the test drugs. During fiberoptic bronchoscopy, the anesthesiologists are responsible for recording patient information, preparation of study drugs, and patient monitoring. Present study was approved by Ethics Committee of Affiliated Hospital of Zunyi Medical University (Reference number: KLL-2020–049), and registered in Chinese Clinical Trials Registry (registration number: ChiCTR2100048790). Informed consents of all included patients were obtained.Patients received 4 ml of 2% aerosolized lidocaine before surgery. All patients received oxygen directly through a mask (2 L/min). All of the patients in the present study were ventilated with a nasopharyngeal ventilation tube. No neuromuscular blocker was used. Patients retained spontaneous breathing. All patients were monitored by electrocardiogram, SpODuring the operation, propofol can be given according to the reaction of patients in the two groups and the length of the examination to maintain the appropriate depth of anesthesia. The total dose of propofol administered during the operation was recorded. Adequate sedation was confirmed by bronchoscopists and anesthetist. The bronchoscopist assessed the satisfaction level to the general anesthesia immediately at the end of inspection. After surgery, when the patients were fully awake, they were asked to evaluate the satisfaction level to the anesthesia. Patients were also asked if they would request the same sedation method for future bronchoscopy (yes or no). The satisfaction of patients and bronchoscopists was assessed by an independent anesthesiologist without knowing the usage of drugs.The primary outcome was the rate of transient hypoxia (SpO