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A comparison of propofol vs. dexmedetomidine for sedation, haemodynamic control and satisfaction, during esophagogastroduodenoscopy under conscious sedation
Author(s) -
Wu Y.,
Zhang Y.,
Hu X.,
Qian C.,
Zhou Y.,
Xie J.
Publication year - 2015
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12282
Subject(s) - dexmedetomidine , propofol , sedation , medicine , anesthesia , esophagogastroduodenoscopy , bradycardia , heart rate , hemodynamics , respiratory rate , mean arterial pressure , adverse effect , blood pressure , surgery , endoscopy
Summary What is known and objective Esophagogastroduodenoscopy ( EGD ) is a common diagnostic procedure which requires sedation for most patients. We undertook a prospective, randomized, double‐blinded study to compare the effect of propofol vs. dexmedetomidine on the sedation of outpatients during EGD . Methods Prior to the procedure, outpatients received either propofol at 0·6 mg/kg, with additional doses of 10–20 mg until the Observer's Assessment of Alertness/Sedation Scale ( OAA /S) score reached 2–4, or dexmedetomidine at a loading dose of 1 μ g/kg over a 10‐min period followed by a 0·5 μ g/kg/h infusion until the OAA /S score reached 2–4. Vital signs, sedation level, adverse events, patients' and endoscopist's satisfaction score, and an evaluation of the recovery time were assessed. Results and discussion Negligible haemoglobin oxygen saturation (SpO 2 ) and respiratory rate variations were observed in both groups, although respiratory depression occurred in two cases (5·9%) in the propofol group. Mean arterial pressure ( MAP ) in the propofol group decreased during the procedure compared with baseline ( P < 0·05) and was also lower in comparison with the dexmedetomidine group ( P < 0·05). Heart rate ( HR ) decreased after the loading dose in the dexmedetomidine group ( P < 0·05). More patients in the propofol group underwent deeper sedation at the beginning of the procedure ( P < 0·05), although the recovery time was comparable between the two groups ( P > 0·05). Three cases (9·1%) in the dexmedetomidine group were delayed because of dizziness, bradycardia and nausea. There was a higher satisfaction score among patients in the propofol group ( P < 0·05), although the endoscopist's satisfaction score was comparable between the two groups ( P > 0·05). What is new and conclusion Propofol and dexmedetomidine provide a relatively satisfactory level of sedation without clinically notable adverse effects during EGD . In addition, patients preferred propofol administration for the deeper sedation and rapid recovery, and dexmedetomidine exhibited minimal adverse effects on respiratory function.