Meta-analysis of the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy.

OBJECTIVE: To perform a meta-analysis on the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy. METHODS: Relevant literature on the sedative effects of midazolam and dexmedetomidine in patients undergoing bronchoscopy was searched in both Chinese and English databases. RESULTS: A total of 19 studies published between 2012 and 2024 were included, involving 38 groups and 2,339 patients. Meta-analysis of continuous variables from fifteen studies reported no statistically significant difference in systolic blood pressure between the study group and the control group (MD = -0.27, 95% CI: -2.16 to 1.61, Z = -0.28, P = 0.78). Similarly, eight studies showed no significant difference in heart rate between the study group and the control group (MD = -0.62, 95% CI: -2.67 to 1.43, Z = -0.59, P = 0.55). Twelve studies demonstrated significantly higher oxygen saturation (SaO2) levels in the study group compared to the control group (MD = 1.88, 95% CI: 0.56 to 3.20, Z = 2.79, P = 0.01). Nine studies indicated that sedation satisfaction was significantly higher in the study group than in the control group (MD = 2.93, 95% CI: 1.16 to 4.70, Z = 3.25, P < 0.01). Ten studies assessed sedation scores, showing no statistically significant difference between groups (MD = 0.32, 95% CI: -0.02 to 0.67, Z = 1.82, P = 0.07). Awakening time, reported in eight studies, also showed no significant difference (MD = -2.70, 95% CI: -5.50 to 0.09, Z = -1.89, P = 0.06). Six studies reported VAS (Visual Analogue Scale) scores, showing a statistically significant difference (MD = -0.46, 95% CI: -0.83 to -0.08, Z = -2.39, P = 0.02). Meta-analysis of dichotomous variables from fourteen studies showed no significant difference in the incidence of adverse events between the groups (OR = -0.10, 95% CI: -0.49 to 0.29, Z = -0.49, P = 0.62). Meta-regression analysis suggested that heterogeneity mainly originated from differences in study type and methodology (P < 0.05). CONCLUSION: Both midazolam and dexmedetomidine demonstrate good sedative effects during bronchoscopy, and their use should be tailored to individual patient conditions.