Comparison of intravenous dexmedetomidine and intravenous remifentanil on onset of action, hemodynamic effects, and awakening time during bronchoscopic anesthesia

BACKGROUND: Bronchoscopy is an endoscopic technique to visualize the inside of the airway for diagnostic and therapeutic purposes. Flexible bronchoscopy causes sympathetic stimulation resulting in hemodynamic instability. Dexmedetomidine can provide excellent sedation in airway management by inducing sedation and analgesia by causing less respiratory depression and less hemodynamic instability. This study aims to determine the comparison of the onset of action, hemodynamic effects, time to recover consciousness, and side effects between the administration of a combination of intravenous propofol-dexmedetomidine and intravenous propofol-remifentanil for bronchoscopy anesthesia.METHODS: A double-blind randomized clinical study was taken on 24 brochoscopy patients in two groups propofol-dexmedetomidine and propofol-remifentanil in Wahidin Sudirohusodo Hospital and its networking hospital. Data were analyzed using the χ2 and Mann-Whitney tests using the SPSS 26.RESULTS: Administration of propofol-remifentanil resulted in a significantly faster onset of action and higher mean arterial pressure than the propofol-dexmedetomidine combination (P<0.05), but the respiratory rate of both groups produced similar results. Administration of propofol-remifentanil resulted in a significantly faster recovery time than the combination of propofol-dexmedetomidine (P<0.05). There are no differences between the two combinations in side effects.CONCLUSIONS: Intravenous propofol-remifentanil provides a better anesthetic option in terms of faster onset of anesthetic action, and faster recovery time compared to the propofol-dexmedotomidine combination with similar side effects.