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已发表论文
右美托咪定鼻喷雾剂作为镇静下纤维支气管镜检查术前用药的有效性和安全性：一项随机对照试验
Authors Zhao G, Qin W, Wu J, Wei S, Jiang X, Qiu H, Du X , Chen L
Received 30 June 2025
Accepted for publication 23 November 2025
Published 4 December 2025 Volume 2025:19 Pages 10735—10749
DOI https://doi.org/10.2147/DDDT.S550551
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Solomon Tadesse Zeleke
Guilin Zhao,* Weiyong Qin,* Jiangdong Wu, Shenqiao Wei, Xiaoqing Jiang, Hang Qiu, Xueke Du, Lini Chen
Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xueke Du, Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China, Tel +86-17307711159, Email duxueke@gxmu.edu.cn Lini Chen Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China, Tel +86-18070927318, Email 906898932@qq.com
Background: Fiberoptic bronchoscopy (FB) under sedation can provoke patient discomfort, cough, and hemodynamic fluctuations. This study evaluated the efficacy and safety of dexmedetomidine nasal spray as a premedication compared to intranasal normal saline and lidocaine.
Methods: A total of 90 patients scheduled for FB under sedation were randomly assigned to three groups. Group D (dexmedetomidine), Group C (control, normal saline), and Group L (lidocaine) received pre-induction nasal sprays via the same metered-dose aerosolization device. At 10 min post-spray, all patients received standard monitored anesthesia care (MAC) with preserved spontaneous ventilation (respiratory rate, RR ≥ 10 breaths/min; peripheral oxygen saturation, SpO2 ≥ 95%). Outcomes included hemodynamic parameters (heart rate, HR; mean arterial pressure, MAP) measured at specific time points (T1-T8), Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scores, cough severity and adverse events.
Results: Group D demonstrated better overall performance. Hemodynamically, HR in Group D was lower than Group C at T3 and T5, and lower than Group L at T5. MAP in Group D was lower than both control groups from T3-T6. Recovery time in Group D was shorter than in both Group C and Group L. Group D also exhibited superior MOAA/S scores (lower at T1, but higher at T6-T8), higher bronchoscopist satisfaction, and a lower incidence of both moderate-to-severe cough and postoperative nausea and vomiting (PONV) compared to the other groups. Respiratory rates were comparable, with Group D showing a higher RR than Group C at T6.
Conclusion: Premedication with dexmedetomidine nasal spray in patients undergoing FB under sedation was associated with more effective suppression of procedure-induced cough, better hemodynamic stability, a lower incidence of PONV, and a faster recovery profile compared to both intranasal saline and lidocaine, without increasing respiratory depression. Consequently, dexmedetomidine nasal spray can effectively and safely enhance patient comfort and safety, and optimize the procedural conditions for the bronchoscopists.
Keywords: dexmedetomidine nasal spray, normal saline, lidocaine, fiberoptic bronchoscopy, sedation
Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xueke Du, Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China, Tel +86-17307711159, Email duxueke@gxmu.edu.cn Lini Chen Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China, Tel +86-18070927318, Email 906898932@qq.com
Background: Fiberoptic bronchoscopy (FB) under sedation can provoke patient discomfort, cough, and hemodynamic fluctuations. This study evaluated the efficacy and safety of dexmedetomidine nasal spray as a premedication compared to intranasal normal saline and lidocaine.
Methods: A total of 90 patients scheduled for FB under sedation were randomly assigned to three groups. Group D (dexmedetomidine), Group C (control, normal saline), and Group L (lidocaine) received pre-induction nasal sprays via the same metered-dose aerosolization device. At 10 min post-spray, all patients received standard monitored anesthesia care (MAC) with preserved spontaneous ventilation (respiratory rate, RR ≥ 10 breaths/min; peripheral oxygen saturation, SpO2 ≥ 95%). Outcomes included hemodynamic parameters (heart rate, HR; mean arterial pressure, MAP) measured at specific time points (T1-T8), Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scores, cough severity and adverse events.
Results: Group D demonstrated better overall performance. Hemodynamically, HR in Group D was lower than Group C at T3 and T5, and lower than Group L at T5. MAP in Group D was lower than both control groups from T3-T6. Recovery time in Group D was shorter than in both Group C and Group L. Group D also exhibited superior MOAA/S scores (lower at T1, but higher at T6-T8), higher bronchoscopist satisfaction, and a lower incidence of both moderate-to-severe cough and postoperative nausea and vomiting (PONV) compared to the other groups. Respiratory rates were comparable, with Group D showing a higher RR than Group C at T6.
Conclusion: Premedication with dexmedetomidine nasal spray in patients undergoing FB under sedation was associated with more effective suppression of procedure-induced cough, better hemodynamic stability, a lower incidence of PONV, and a faster recovery profile compared to both intranasal saline and lidocaine, without increasing respiratory depression. Consequently, dexmedetomidine nasal spray can effectively and safely enhance patient comfort and safety, and optimize the procedural conditions for the bronchoscopists.
Keywords: dexmedetomidine nasal spray, normal saline, lidocaine, fiberoptic bronchoscopy, sedation