Safety and efficacy of dexmedetomidine for flexible bronchoscopy: A systematic review and meta-analysis

Table 1 Study characteristics, n (%)

Ref.	Study design	Population	Intervention	Control	Sample size		Males		Study duration	DEX dose	Route of administration	Purpose of bronchoscopy
					Intervention	Control	Intervention	Control
Magazine et al[27], 2024	RCT	Patients aged 18-65 years undergoing FB in a tertiary care hospital in South India	DEX (0.75 μg/kg)	Midazolam -fentanyl (0.035 mg/kg and 25 μg)	31	31	18 (58)	20 (64.5)	41 months	0.75 µg/kg	Intravenous infusion	To visualize the bronchial tree and perform necessary sampling procedures
Zhou et al[21], 2024	RCT	Patients aged 18-70 undergoing painless flexible fiberoptic bronchoscopy	DEX (4 μg/mL) -remifentanil (20 μg/mL)	Remimazolam (1 mg/mL) -remifentanil (20 μg/mL)	182	182	116 (63.7)	126 (69.2)	18 months	4 μg/mL	Intravenous infusion	Evaluation of unexplained cough, hemoptysis, localized wheezing, hoarseness, suspected lung abnormalities, lung disease evaluation, and preoperative assessment
Magazine et al[28], 2021	RCT	Patients (aged 18-65, requiring diagnostic FB)	DEX (0.75 μg/kg)	Midazolam (0.035 mg/kg)	24	24	13 (54.2)	10 (41.7)	17 months	0.75 µg/kg	Intravenous infusion	Diagnostic
Kim et al[29], 2021	RCT	Patients undergoing EBUS-TBNA	DEX (0.25-0.75 μg/kg)	Midazolam	48	54	33 (68.8)	39 (72.2)	14 months	0.25-0.75 μg/kg	Intravenous infusions	Diagnostic
Zhang et al[31], 2021	RCT	Patients undergoing bronchoscopy	DEX combined with midazolam	Fentanyl combined with midazolam	222	211	139 (62.6)	126 (59.7)	-	-	Intravenous infusion	Diagnostic
Magazine et al[30], 2020	RCT	Patients aged 18-65 requiring diagnostic FB	DEX (0.5 μg/kg)	Midazolam (0.035 mg/kg)	27	27	19 (70.4)	14 (51.9)	22 months	0.5 μg/kg	Intravenous infusion	Diagnostic bronchoscopy to evaluate pulmonary pathologies, assess centrally located tumors, and identify the cause of hemoptysis
Goneppanavar et al[32], 2015	RCT	Patients aged 18-70 years undergoing FB	DEX (1 μg/kg)	Midazolam (0.02 mg/kg)	27	27	20 (74.1)	24 (88.9)	-	1 μg/kg	Intravenous infusion	Evaluation of the airway in the Department of Pulmonary Medicine
Liao et al[33], 2012	RCT	Postoperative adult patients in the intensive care unit who had undergone thoracic surgery and were referred for bronchoscopy	DEX	Midazolam	99	99	61 (61.6)	62 (63.3)	12 months	-	Intravenous infusion	Postoperative evaluation in patients who had undergone thoracic surgery
Kumari et al[34], 2021	RCT	Patients undergoing EBUS-TBNA	DEX (1 μg/kg)	Midazolam (2 mg/kg)	99	98	56 (56.6)	50 (51)	-	1 μg/kg	Intravenous infusion	To perform EBUS-TBNA for diagnostic evaluation
Riachy et al[22], 2018	RCT	Patients aged 18-70 undergoing elective FB	DEX (0.5 μg/kg)	Alfentanil (10 μg/kg)	53	55	31 (58.5)	30 (55.6)	25 months	0.5 μg/kg	Intravenous infusion	Diagnostic evaluation of pulmonary disease
Yuan et al[23], 2016	RCT	Patients aged 20-75 years with ASA I-III undergoing elective FB	DEX (1 μg/kg) + fentanyl (1 μg/kg)	Propofol (4 μg/mL) + fentanyl (1 μg/kg)	50	50	27 (54)	22 (44)	6 months	1 μg/kg	Intravenous infusion	Various procedures (e.g., bronchoalveolar lavage, transbronchial biopsy)
Shoukry et al[24], 2016	RCT	Adult patients (18-70 years old, ASA I-III) undergoing elective fiberoptic bronchoscopy	DEX (1 μg/kg) + fentanyl (1 μg/kg)	Propofol (0.5-1 mg/kg) + fentanyl (1 µg/kg)	36	36	23 (63.9)	25 (69.4)	9 months	1 μg/kg	Intravenous infusion	Diagnostic purposes (e.g., lung cancer staging, hemoptysis, interstitial lung disease)
Mani et al[26], 2015	RCT	Patients undergoing FB	DEX (1 μg/kg)	Propofol (1 mg/kg)	30	30	-	-	-	1 μg/kg	Intravenous infusion	Diagnostic FB
Ryu et al[25], 2012	RCT	Patients, aged 18-70 years, ASA I-III, undergoing elective diagnostic FB	DEX (0.4-2 μg/kg) + propofol (0.5 mg/kg)	Propofol (0.5 mg/kg) + remifentanil (1-5 μg/kg)	35	35	20 (57)	18 (51)	7 months	0.4-2 μg/kg	Intravenous infusion	Diagnostic FB

ASA: American Society of Anesthesiologists; DEX: Dexmedetomidine; EBUS-TBNA: Endobronchial ultrasound-guided transbronchial needle aspiration; FB: Flexible bronchoscopy; RCT: Randomized controlled trial.