Table 4. Summary of clinical studies of propofol in flexible bronchoscopy.
| Article | Study type | Drug | Main results |
| Clarkson [54] | Randomised, double-blind, prospective-controlled study | Propofol (n=21) versus midazolam (n=20) | More rapid onset and recovery from sedation seen in the propofol group No significant difference in the amount of topical anaesthetic required or in oxygen desaturation |
| Crawford [55] | Randomised, double-blind, prospective-controlled study | Propofol (n=21) versus midazolam–alfentanil (n=21) | In three patients in the midazolam–alfentanil and five in the propofol group the depth of sedation exceeded the moderate level Recovery to an appropriate level was more rapid in the latter group Oxygen saturations decreased in both groups and there were no significant differences in blood pressure Those in the midazolam group had more amnesia and longer recovery time |
| Gonzalez [5] | Randomised, single-blind, prospective-controlled study | Propofol (n=9) versus no sedation (n=9) | Less cough, pain, sensation of asphyxiation, total amnesia and improved tolerance of the procedure in the propofol group No differences in oxygen saturations between the groups |
| Hwang [47] | Randomised, double-blind, prospective-controlled study | Propofol–alfentanil (n=138) versus propofol–ketamine (n=138) for patient-controlled sedation | Patients in the propofol–ketamine group reported greater amnesia and satisfaction Haemodynamic stability and adequate oxygenation during the procedure in both groups; however, a significant drop in oxygen saturations below 90% was seen in both groups immediately before the procedure This was transient and with no sequelae |
| Clark [20] | Randomised, double-blind, prospective-controlled study | Propofol (n=43) versus midazolam (n=39) | Propofol resulted in faster recovery from sedation and patient tolerance and satisfaction were improved There were no differences in operator satisfaction Safely administered by non-anaesthetis |
| Stoltz [56] | Randomised, non-blinded, prospective-controlled study | Propofol (n=100) versus midazolam–hydrocodone (n=100) | Mean oxygen saturation and desaturation below 90% were similar in both groups Patients receiving propofol had less tachycardia during the procedure and faster recovery from sedation |
| Grendelmeier [12] | Prospective case series | Propofol (n=440) | Systolic blood pressure dropped below 90 mmHg in 15.4% and oxygen saturation dropped below 90% in 16.4% of patients but some of these had higher American Society of Anesthesiology scores and were already hypotensive or hypoxaemic prior to the sedation None of the patients required intubation |
| Lo [21] | Randomised, non-blinded, prospective-controlled study | Propofol (n=243) versus midazolam (n=249) | Bispectral index-guided propofol infusion is as safe as clinically judged midazolam sedation The proportion of patients with hypoxemia or hypotensive events were not different in the two groups but those in propofol group had the lowest mean arterial blood pressure and oxygen saturation readings Those in the propofol group had less cough, improved procedure tolerance and faster recovery from sedation |
| Yoon [57] | Randomised, double-blind, prospective-controlled study | Propofol (n=32) versus propofol–alfentanil (n=32) | They did not find differences in patient or bronchoscopist satisfaction or in degree of coughing but those in the alfentanil group had significantly lower oxygen saturation levels. However, the lower levels of oxygen saturation reported in the alfentanil are most likely not clinically significant |
| Schlatter [58] | Randomised, double-blind, prospective-controlled study | Propofol (n=154) versus propofol–hydrocodone (n=146) | This combination suppressed coughing and reduced patient discomfort during flexible bronchoscopy compared to placebo alone with no differences in complication rates |
| Carmi [59] | Randomised, non-blinded, prospective-controlled study | Propofol (n=56) versus midazolam–alfentanil (n=59) | Those in the midazolam–alfentanil group rather than the propofol group had higher carbon dioxide tension values and required more oxygen supplementation or airway support; however, both were considered equally safe and effective |