Introduction:Flexible-bronchoscopy (FOB) is indicated for diagnosis of various pulmonary disorders. FOB is done with local lignocaine used to reduce cough episodes. Nebulized dexmedetomidine (NebDex) has been shown to have local anaesthetic as well as systemic sedative properties.

Aims & Objective:This study investigate the role of NebDex prior to FOB to reduce cough episodes. Primary outcome was to compare moderate to severe cough in study subjects.

Methods:It this double-blind RCT, intervention arm received NebDex (2?g/kg) whereas control arm were nebulized with normal saline.

Results:100 subjects were randomized in a ratio of 1:1. Mean age of study population was 49.5±15.6 years with majority being males (64%). Baseline characteristics were similar in both groups. A higher number of cases in NebDex arm underwent bronchoalveolar lavage (50% versus 24%) whereas a higher number of subjects in control groups underwent check-bronchoscopy (42% versus 20%). The difference in moderate to severe cough in the two groups was not statistically significant (22% vs. 18%) respectively. Dose of anaesthetic drugs (fentanyl, midazolam, locally instilled lignocaine) was also similar in the two groups. However, the discomfort levels using VAS score, of both the patient as well as of the operator were significantly lower in the intervention arm (51±20.6 versus 72.2±13.1, for patient-reported-discomfort and 12.5±9.8 versus 36.6±27.2, for operator-discomfort). Mean Richmond-Agitation-Sedation-Scale score was significantly lower in the NebDex arm (-0.22±0.1 versus 0.12±0.1).

Conclusion: NebDex has limited topical action to reduce cough episodes as compared to normal saline in FOB.