Clinical study of remimazolam alone or combined with remifentanil for sedation of tracheal intubation under awake fiberoptic bronchoscopy
Zhou Xiaorui
Xue Fushan
Wang Sheng
Li Chengwen
Abstract：Objective To investigate the clinical effect of remimazolam alone or combined with remifentanil for sedation in awake fiberoptic bronchoscopic tracheal intubation(AFOI).Methods Sixty patients who underwent elective AFOI surgery in Beijing Friendship Hospital,Capital Medical University from August 2021 to February 2023 were selected as the research objects.The patients were divided into remimazolam alone group(RM group)and remimazolam combined with remifentanil group(RR group)by random number table method,with 30 cases in each group.Patients in the RM group received only a continuous infusion of remimazolam 0.6 mg/(kg·h).RR group received remimazolam 0.6 mg/(kg·h)and remifentanil 0.05 µg/(kg·min)combined infusion.AFOI operation-related evaluation,sedation level and hemodynamic indexes at different time points[drug infusion at 1 min(T1)and 3 min(T2),before fiberoptic bronchoscope entering the glottis(T3),and after tracheal tube entering the trachea(T4)]were compared between the two groups.Results The response to fiberoptic bronchoscopy intubation,cough severity and post-intubation tolerance score,intubation time,awareness and willingness to accept AFOI score in RR group were lower/shorter than those in RM group(all P＜0.001).The Modified Observer's Assessment of Alertness/Sedation score and bispectral index at T2,T3 and T4 in RR group were lower than those in RM group(all P＜0.05).The incidence of hypoxemia and deep sedation was higher and the incidence of hypertension and tachycardia was lower in the RR group than in the RM group[44.8％(13/29)vs 0(0/30),48.3％(14/29)vs 3.3％(1/30),31.0％(9/29)vs 63.3％(19/30),34.5％(10/29)vs 73.3％(22/30)](all P＜0.05).Conclusions Remimazolam alone can provide effective sedation for AFOI and is safe and reliable.Remimazolam combined with remifentanil can provide better intubation conditions and comfort,but may increase the risk of respiratory depression.
Keywords：SedationAwake fiberoptic bronchoscopy tracheal intubationRemimazolamRemifentanil
Publication Date：2024-05-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 699-703 )