فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Flexible bronchoscopy (FB) carries risks such as haemodynamic instability and oxygen desaturation related to sedation. The selection of sedative–analgesic agents can influence patient safety and procedural outcomes, making optimal sedation strategies a key area of research. This retrospective single-center study aimed to compare three sedative–analgesic regimens used during FB with respect to haemodynamic and oxygenation outcomes.    Methods: Medical records of 648 adult patients undergoing FB between 2020 and 2023 were analyzed. Patients were categorized into three groups: midazolam alone (M), midazolam plus fentanyl (MF) and midazolam plus fentanyl plus propofol (MFP). Pre- and post-procedural systolic blood pressure, heart rate and oxygen saturation were compared using appropriate statistical tests and p-values were calculated to determine significance.    Results: A total of 648 patients were analyzed (57.3% female; mean age 61.8 ± 13.9 years). Procedures were performed with the M group (42.3%), MF group (31.2%), or MFP group (26.5%). Mean midazolam doses were 3.4 ± 1.2 mg, 2.5 ± 0.9 mg and 2.3 ± 0.9 mg in M, MF and MFP groups, respectively (P = 0.001). SBP increased by +14.2 mmHg in M, +6.8 mmHg in MF and +11.1 mmHg in MFP (P < 0.001), while HR rose by +8.3, +13.5 and +10.4 bpm, respectively (P < 0.001). SpO₂ declined by 1.1 ± 4.5% in M, 0.14 ± 2.7% in MF and 0.65 ± 3.2% in MFP (P = 0.021). Hypoxia occurred in 5.4%, 1.6% and 1.8% of patients, respectively (P < 0.001). After adjustment for age and sex, the MF group showed a smaller SBP increase and higher HR rise versus M (P < 0.05)    Conclusion: Combined sedation was associated with better hemodynamic stability, fewer hypoxia episodes, and improved procedure tolerance compared to midazolam alone.