Monitored Anesthesia Care with Dexmedetomidine in Patients Undergoing Pleuroscopy: Effect on Oxygenation and Respiratory Function. A Prospective, Single-center Study

Introduction: Although pleuroscopy is a safe procedure with a low complication rate it still requires the use of procedural sedation and analgesia. Objectives: This prospective study evaluated the effects of dexmedetomidine administration on oxygenation and respiratory function in patients undergoing diagnostic or therapeutic pleuroscopy. Materials and Methods: 55 enrolled patients received either a dexmedetomidine infusion or conventional (midazolam/fentanyl) sedation. Arterial blood gas and spirometry measurements were obtained at baseline and at predetermined endpoints. Drug consumption, time to recover from sedation, perioperative pain and adverse events were also recorded. Results: A lesser postoperative decrease in FEV1 in the dexmedetomidine group [mean (95%CI): 2 (-13-16) vs. 20 (11-29), p=0.039] was observed. Additionally, a significant reduction in midazolam (1.4±1mg vs 4±1.3mg, p Conclusions: This study demonstrated that dexmedetomidine use provides a lower decrease in FEV1 after pleuroscopy, reduces significantly the consumption of other sedatives and analgesics and accelerates postoperative awakening. Therefore dexmedetomidine can constitute a valuable alternative sedation agent in patients undergoing pleuroscopy, given its superior pharmacokinetic and pharmacodynamic profile.