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首页> 外文期刊>Journal of bronchology: dedicated to the art and science of bronchoscopy and related disciplines >Optimal Premedication for Diagnostic Flexible Fiberoptic Bronchoscopy Without Sedation A Randomized Phase II Study
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Optimal Premedication for Diagnostic Flexible Fiberoptic Bronchoscopy Without Sedation A Randomized Phase II Study

机译：无镇静的诊断性柔性纤维支气管镜的最佳处方治疗II期随机研究

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Since the introduction of the flexible fiberoptic bronchos-copy (FFB), no consensus has been reached concerning premedication. We investigated the effect of 4 premedication regimes on 6 outcomes (patients' comfort, dyspnea and coughing experienced by the patient, coughing and bronchial secretion observed by the bronchos-copist and supplemental instilled tetracaine) in patients undergoing FFB. Two hundred forty-seven patients underwent 258 FFBs and were randomly selected to receive the following premedication regimes: 0.5 mg atropine intramuscularly and 20 mg codeine (n = 48), 2 mL (0.25 mg/mL) inhaled ipratropium bromide (n = 50), 20 mg codeine (n = 76), and no premedication (n = 84).The amount of endo-scopically applied tetracaine was registered during the FFB. Patients and the bronchoscopists filled out a questionnaire and a semiquanti-tative visual analog scale regarding the previously mentioned outcomes after the procedure. Patient comfort was significantly higher in the patient group using atropine and codeine as premedication (P = 0,001). Female gender and having had a prior bronchoscopy were negative predictors for patient comfort (P = 0.006 and P = 0.021), Patients using codeine or atropine and codeine experienced less coughing (P = 0.044, P = 0.050). In conclusion, codeine showed a beneficial effect on suppressing cough. The role of atropine seems to be limited to its sedative action, improving patients' comfort. However, for this purpose, other sedatives could be preferred. FFB can be performed safely without premedication. Smoking has a negative impact on dyspnea and coughing during FFB.
机译：自从引入柔性纤维支气管镜（FFB）以来，就预防用药尚未达成共识。我们调查了4种药物治疗方案对FFB患者的6种结局（患者的舒适度，呼吸困难和咳嗽，支气管复制师和补充滴注丁卡因观察到的咳嗽和支气管分泌物）的影响。 247名患者接受了258次FFB，并随机选择接受以下处方治疗方案：肌内注射0.5 mg阿托品和20 mg可待因（n = 48），吸入异丙托溴铵（n = 50）2 mL（0.25 mg / mL）。 ，20毫克可待因（n = 76），且未进行预防用药（n = 84）。FFB期间记录了内镜下应用丁卡因的量。患者和支气管镜医师针对该手术后的结局填写了调查表和半定量视觉模拟量表。使用阿托品和可待因作为预用药的患者组的患者舒适度显着更高（P = 0,001）。女性性别且曾接受过支气管镜检查是患者舒适度的阴性预测指标（P = 0.006和P = 0.021），使用可待因或阿托品和可待因的患者咳嗽较少（P = 0.044，P = 0.050）。总之，可待因在抑制咳嗽方面显示出有益的作用。阿托品的作用似乎仅限于其镇静作用，可提高患者的舒适度。但是，为此目的，其他镇静剂可能是首选。 FFB可以安全地进行而无需预先用药。吸烟对FFB期间的呼吸困难和咳嗽有负面影响。

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