Improvement of Anxiety, Coughing, Breathlessness and Pain Control in The Management of Bronchoscopy by Adding Alprazolam

Authors

  • Yanny Octavia Sally Ride Universitas Negeri Sebelas Maret
  • Yusup Subagio Sutanto Universitas Negeri Sebelas Maret
  • Debree Septiawan Universitas Negeri Sebelas Maret

DOI:

https://doi.org/10.36497/jri.v39i4.74

Keywords:

alprazolam, bronchoscopy, HADS, modified Borg, pain VAS

Abstract

Background: Anxiolytic premedication can reduce anxiety, improving procedural tolerance, and reduce postbronchoscopic complications. There was ongoing debate about the safety of bronchoscopist-administered sedation. Alprazolam as a surgical premedication can reduce anxiety. Alprazolam can be used as an adjuvant analgesic, to reduce anxiety-related breathlessness, and to reduce coughing as adjuvant antitussive. The study aimed to evaluate the effectiveness of alprazolam in patients undergoing bronchoscopy. Methods: A clinical study with experimental quasi pre-post test control group design, using consecutive sampling was performed in patients with lung tumor undergoing bronchoscopy in dr.Moewardi Hospital from February to March 2019. The study subjects were divided in experimental (alprazolam) and control groups (without alprazolam). The Hospital Anxiety and Depression Scale (HADS), VAS for pain score, modified Borg score, and VAS for cough were measured in baseline, before, and after bronchoscopy. Results: Thirty two lung subjects were included in this study. The intervention groups showed decreased HADS score pre and post bronchoscopy (6.56±2.83 and 6.88±2.63), pain VAS scores (15.00±10.95 and 9.69±11.61), cough VAS score (11.56±8.89 and 27.19±17.89), and these were different significantly compared to control group. We found decreased mean of modified Borg in the study group though they were not significant compared to the control group. Conclusion: Alprazolam controlled anxiety, coughing, and pain in patients undergoing bronchoscopy. Alprazolam minimized breathlessness after bronchoscopy. (J Respir Indo. 2019; 39(4): 245-55)

Downloads

Download data is not yet available.

Author Biographies

  • Yanny Octavia Sally Ride, Universitas Negeri Sebelas Maret
    Bagian Pulmonologi dan Kedokteran Respirasi, Fakultas Kedokteran
  • Yusup Subagio Sutanto, Universitas Negeri Sebelas Maret
    Bagian Pulmonologi dan Kedokteran Respirasi, Fakultas Kedokteran
  • Debree Septiawan, Universitas Negeri Sebelas Maret
    Bagian Ilmu Kesehatan Jiwa, Fakultas Kedokteran

References

Kupeli E, Feller-Kopman D, Mehta AC. Diagnostic bronchoscopy. In: Broaddus VC editor. Murray and nadel’s textbook of respiratory medicine. 6th ed. Philadelphia: Elsevier; 2016. p. 372-8.

Antony P, Deshmukh H. Bronchoscopic finding of flexible bronchoscopy. Int J Res Med Sci. 2018;6(2):591-6.

Allemani C, Weir HK, Carreira H, Harewood R, Spica D, Wang XS, et al. Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 2015;385:977-1010.

Martin-Loeches I, Artigas A, Gordo R. Current status of fiberoptic bronchoscopy in intensive care medicine. Med Intensiva. 2012;36(9):644-9.

Leiten EO, Martinsen EM, Bakke PS, Eagan TM, Gronseth R.. Complications and discomfort of bronchoscopy: a systematic review. Eur Clinl Resp J. 2016;3:1-9.

Jose RJ, Shaefi S, Navani N. Sedation for flexible bronchoscopy: current and emerging evidence. Eur Respir Rev. 2013;22(128):106-16.

Joshi A, Ansari AS, Mazumdar S, Ansari S. A comparative study to assess the effect of oral alprazolam as premedication on vital parameters of patients during surgical of impacted mandibular third molars. Contemp Clin Dent. 2016;7(4):464-8.

Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. Korean J Anesthesiol. 2015;68(4):346-51. J Addict Med. 2018;12(1):4–10.

Madiyono B, Moeslichan MS, Budiman I, Purwanto S. Perkiraan besar sampel. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 5 ed. Jakarta: Sagung Seto; 2014. p. 360–5.

Tumbelaka AR, Riono P, Wirjodiarjo M, Pudjiastuti P, Firman K. Pemilihan uji hipotesis. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 5ed. Jakarta: Sagung Seto; 2014. p. 338–41.

World Health Organization. Cancer: key facts. [Cited on 2019 Mar 24th]. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer.

Cheng TD, Cramb SM, Baade PD, Youlden DR. The international epidemiology of lung cancer. J of Thorac Onc. 2016;11(10):1653-71.

Perhimpunan Dokter Paru Indonesia. Pendahuluan. In: Syahruddin E, Jusuf A, editors. Kanker paru. UI Press. 2018. p. 3-5.

Hashibe M, Siwakoti B, Wei M, Thakur BK, Pun CB, Shrestha BM, et al. Socioeconomic status and lung cancer risk in Nepal. As Pac J of Canc Prev. 2011;10:1083-6.

Menvielle G, Truong T, Brenner H. Education and lung cancer among never smokers. Epidemiology. 2014;25(6):934-6.

Froudarakis ME, Pleural effusion in lung cancer. Respiration. 2010;83:367-73.

De Boer GM, Tuurk Y, Van Waning VH, Braunstahl GJ. Bronchoscopy: oral or nasal. J Bronchol Intervent Pulmonol. 2017;24(2):125-9.

Lechtzin N, Rubin HR, White P, Jenckes M, Diette GB. Patients satisfaction with bronchoscopy. Am J Respir Crit Care Med. 2002;166:1326-31.

Tetikkurt C, Yasar I, Yilmaz N, Kara BY, Disci R. Role of anxiety on patient intolerance during bronchoscopy. Brit J of Med Res. 2014;4(11):2171-80.

Polanski J, Chabowski M, Chudiak A, Uchmanowicx B, Janczak D, Rosinczuk J. Et al. Intensity of anxiety and depression in patients with lung cancer in relation to quality of life. Adv Exp Med Biol. 2018;1023:29-36.

Verster JC, Volkerts ER. Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam. CNS Drug Rev. 2006;10(1):44-9.

Shavakhi A, Soleiman SS, Gholamrezaei A, Khodadoostan M, Shavakhi S, Tahery A, et al. Premedication with alprazolam in adults undergoing deagnostic upper gastrointestinal endoscopy. Endoscopy. 2014;46:633-9.

Sebghatollahi V, Tabesh E, Gholamrezaei A, Zandi AR, Minakari M, Shavakhi A. Premedication with benzodiazepines for upper gastrointestinal endoscopy; comparison between midazolam dan alprazolam. J Res Med Sci. 2017;133(22):1-6.

Harle AM, Blackhall FH, Molassiotis A, Yorke J. Cough in patients with lung cancer. Chest. 2019;155(1):103-13.

Dang D, Robinson PC, Winnicki S, Jersmann HP. The safety of flexible fibreoptic bronchoscopy and proceduralist-administered sedation: a tertiary referral centre experience. Intern Med J. 2012;42:300-5.

Buchanan D, Milroy R, Baker L, Thompson AM, Levack PA. Perceptions of anxiety in lung cancer patients and their support network. Supp care Canc. 2010;18:29-32.

Stolz D, Chhajed PN, Leuppi JD, Brutsce M. Cough supression during flexible bronchoscopy using combined sedation with midazolam and hydrocodone. Thorax. 2014;59:773-6.

Ni YL, Lo YL, Lin TY, Fang YF, Kuo HP. Conscious sedation reduces patient discomfort and improves satisfaction in flexible bronchoscopy. Chang Gung Med J. 2010;33(4):443-52.

Spiro SG, Gould MK, Colice GL. Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests and paraneoplastic syndromes. Chest. 2003;132(3):149-54.

Kathiresan G, Clement RF, Sankaranarayanan MT. Dyspnea in lung cancer: a systematic review. Lung Canc Auckl. 2010;1:141-50.

Williams AC, Grant M, Hayter J. Dyspnea management in early stage lung cancer. J Hosp Palliat Nurs. 2012;14(5):1-7.

Kloke M, Cherny N. Treatment of dyspnoea in advanced cancer patients. Ann of Oncol. 2015;26(5):169-72.

Tremmas I, Petsatodis G, Potoupis M, Laskou S. Monitoring changes in quality of life in patients with lung cancer. J Cancer. 2018;9(10):1731-6.

De Marinis F, Pereira JR, Fossella F, Perry MC, Recj M, Salzberg M, et al. Lung cancer symptom scale outcomes in relation to standard efficacy measures. J Thorac Oncol. 2008;3(1):30-6.

Martinez KA, Snyder CF, Malin JL, Dy SM. Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer? J Pain Symptom Manage. 2015;48:1050-9.

Nurwidya F, Syahruddin E, Yunus F. Pain management in lung cancer. Adv Respir Med. 2016; 84(6): 331-6.

Joseph TT, Krishna HM, Kamath S. Premedication with gabapentin, alprazolam or placebo for abdominal hysterectomy: effect on pre-operative anxiety, post-operative pain, and morphine consumption. Indian J Anaesth. 2014;58(6): 693–9.

Baradaran M, Hamidi MR, Firoozabad MM, Kezemi S. Alprazolam role in the analgesic effect of ibuprofen in postendodontic pain. Caspian J Intern Med. 2014;5(4):196-201.

Shetkar P, Jadhav GR, Mittal P, Surapanemi S, Kalra D, Sakri M, et al. Comparative evaluation of effect of preoperative alprazolam and diclofenac potassium on success of inferior alveolar, Vazirani-Akinosi, and Gow-Gates techniques; randomized controlled trial. J Conserv Dent. 2016;19(5):390-5.

Avanaz A, Yaprak M, Dogru V, Mesci A. The effect of alprazolam as preoperative adjuvan analgesic on postoperative pain in laparoscopic donor nephrectomy patients. Trans Preceed. 2019;1(107):91-7.

Downloads

Published

2019-10-10

Issue

Section

Original Article

How to Cite

Improvement of Anxiety, Coughing, Breathlessness and Pain Control in The Management of Bronchoscopy by Adding Alprazolam. (2019). Jurnal Respirologi Indonesia, 39(4), 245-255. https://doi.org/10.36497/jri.v39i4.74

Similar Articles

1-10 of 36

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 3 > >>