Dexmedetomidine versus midazolam for sedation in upper gastrointestinal endoscopy

Abstract

Objectives: To investigate the efficacy and safety of sedation with dexmedetomidine in upper gastrointestinal endoscopy. Methods: Patients with ASA physical status I-II undergoing elective upper gastrointestinal endoscopy were randomly allocated to receive dexmedetomidine or midazolam for conscious sedation. Continuous peripheral oxygen saturation (SpO 2 ), heart rate, mean arterial pressure (MAP), Ramsay Sedation Scale (RSS) and numeric rating scale pain scores were recorded before, during and after the procedure. Patients completed a post-procedure satisfaction questionnaire. Results: Patients in the midazolam group (n ¼ 30) experienced a significant decrease in MAP during sedation compared with pre-sedation values. Patients in the dexmedetomidine group (n ¼ 30) had significantly higher SpO 2 and RSS scores during sedation than those in the midazolam group. Overall satisfaction was higher in the dexmedetomidine group than the midazolam group. There were no clinically significant complications in either group. Conclusion: Dexmedetomidine has a good safety profile and is an effective sedative for use in upper gastrointestinal endoscopy.

Dexmedetomidine versus midazolam for gastrointestinal endoscopy: A meta‐analysis

“…A further six studies were then excluded because of a lack of control groups ( n = 2), comparison of dexmedetomidine with propofol ( n = 2), and comparison of dexmedetomidine with placebo ( n = 2) . Finally, nine studies were included in the systematic review and meta‐analysis . The characteristics of these studies are summarized in Table .…”

“…The study by Wu et al . had potential bias in selective reporting and other aspects because it was a retrospective randomized study …”

“…Dexmedetomidine has been reported to facilitate the sedation of patients while maintaining their consciousness and to maintain stable respiration and circulation. Several randomized controlled trials (RCT) have evaluated the efficacy of dexmedetomidine in comparison with midazolam for gastrointestinal endoscopy . Unfortunately, none of these trials enrolled a sufficient number of patients to produce an adequate power in order to detect meaningful differences.…”

The effects of intravenous dexmedetomidine on spinal anesthesia: comparision of different dose of dexmedetomidine

“…It is correlated with cooperative sedation, which is different from the clouding of consciousness that occurs with drugs that act on GABA receptors, such as propofol or midazolam [17]. In a previous study, dexmedetomidine showed better oxygen saturation and RSS than midazolam [18]. In the present study, dexmedetomidine provided sufficient sedation (0 vs 83.6 ± 40.4 vs 89.9 ± 42.7 min), and the duration did not differ between the D-0.5 and D-1 groups.…”

Dexmedetomidine as a Sedative in the Awake Implantation of a Neuromodulative System

“…Earlier randomized controlled trials evaluating the use of dexmedetomidine alone during small diagnostic and therapeutic procedures showed promising results. However, a potential disadvantage of dexmedetomidine is its hemodynamic side effects, which include hypotension and bradycardia …”