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document
Benzodiazepine and opioid sedation attenuate the sympathetic response to fiberoptic bronchoscopy . Prophylactic labetalol gave no additional benefit . Results of a randomized double-blind placebo-controlled study . BACKGROUND Hypertension and tachycardia are common during fiber-optic bronchoscopy ( FOB ) , and this may lead to cardiac ischemia . The prophylactic addition of a beta-adrenergic anatagonist might mask this response and prevent the deleterious cardiovascular effects of FOB . METHODS We performed a randomized double-blind placebo-controlled trial of labetalol 10mg iv given with midazolam-alfentanil sedation . We monitored heart rate ( HR ) and systolic/diastolic blood pressure ( SBP/DBP ) throughout the bronchoscopy and calculated the rate-pressure product ( RPP= ( HRxSBP ) /100 ) . One-hundred twenty patients were enrolled . RESULTS In the placebo group , there was no rise in HR , SBP , DBP or RPP , and there was no difference between the placebo and labetalol groups . Adverse events during bronchoscopy were similar in both groups . In a subgroup of patients undergoing interventional bronchoscopy , there was a trend towards lower SBP ( p=0.06 ) . CONCLUSIONS Patients undergoing FOB under adequate midazolam-alfentanil sedation do not develop excessive sympathetic drive that may lead to cardiac stress . The addition of labetalol did not confer additional benefit or risk to the patients . ( ClinicalTrials.gov number , NCT00394537 ) .
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Intervention_Pharmacological
Benzodiazepine
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Intervention_Pharmacological
opioid sedation
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Intervention_Physical
fiber-optic bronchoscopy ( FOB )
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Intervention_Pharmacological
beta-adrenergic anatagonist
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Intervention_Pharmacological
labetalol 10mg iv given with midazolam-alfentanil sedation
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Intervention_Pharmacological
labetalol
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Intervention_Pharmacological
midazolam-alfentanil sedation
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Outcome_Physical
fiberoptic bronchoscopy
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Outcome_Physical
cardiovascular effects of FOB
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Outcome_Physical
heart rate ( HR ) and systolic/diastolic blood pressure ( SBP/DBP )
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Outcome_Physical
HR
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Outcome_Physical
SBP , DBP
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Outcome_Physical
RPP
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Outcome_Adverse-effects
Adverse events during bronchoscopy
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Outcome_Physical
SBP
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Participant_Condition
fiberoptic bronchoscopy
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Participant_Condition
fiber-optic bronchoscopy ( FOB )
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Participant_Sample-size
One-hundred twenty
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Participant_Condition
FOB