Dexmedetomidine versus propofol for sedation during gastrointestinal endoscopy in pediatric patients

Hasanin, Ashraf S.; Sira, Ahmad Mohamed

doi:10.1016/j.egja.2013.09.006

Cited by 19 publications

(33 citation statements)

References 18 publications

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“…Dexmedetomidine compared with propofol showed a significantly prolonged recovery time, which was defined as the time from discontinuation of drug intake until achievement of a Steward Recovery Score of 6. HR was significant lower in the dexmedetomidine group . Tammam compared IV and IM dexmedetomidine.…”

Section: Resultsmentioning

confidence: 89%

“…compared dexmedetomidine with midazolam and showed significantly less use of rescue medication and a higher rate of adequate sedation for the dexmedetomidine group, without any significant differences in MAP, HR and SpO 2 in both arms. All trials in children showed respiratory safety during dexmedetomidine infusion compared to the control group …”

Section: Resultsmentioning

confidence: 98%

“…During these kinds of procedures, an equilibrium between patient cooperation and patient comfort is required for an optimal outcome. Dexmedetomidine, whether or not in combination with a local anesthetic, can induce this required level of sedation (minimal/conscious) . Several randomized controlled trials (RCTs) have investigated the use of dexmedetomidine as a sole sedative agent during small procedures …”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

et al. 2016

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Dexmedetomidine is an upcoming agent with sedative, anxiolytic, and analgesic properties. This review summarizes empirical evidence for the efficacy of dexmedetomidine as a sole sedative agent, and its effectiveness for small diagnostic and therapeutic procedure, in comparison with other frequently used sedatives. All randomized controlled trials on the effect of dexmedetomidine were reviewed. Pain level, patient satisfaction, operator satisfaction, procedure duration, recovery time, and hemodynamic and respiratory characteristics were examined. A total of 1993 patients (1,621 adults; 372 children) from 35 studies were included. In the adult studies, dexmedetomidine yielded significantly lower pain levels compared to the other sedatives (in 31.25% of the included studies) and significantly more patient satisfaction (68.2%). In studies on children, more favorable results concerning respiratory safety and the level of adequate sedation were found compared to the control sedatives. Implications for future studies are discussed.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

et al. 2016

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“…The secondary outcomes were: (a) patient's comfort and operator's comfort throughout the procedure, measured as the response to the question "What score would you give to the comfort during the procedure?" — from 1 (bad) till 4 (excellent); (b) number of adjustments made during dexmedetomidine or propofol titration; (c) level of sedation measured with the Ramsey Sedation Scale; (4) sedation side effects (i.e. desaturation, airway intervention, laryngospasm, hypotension, bradycardia, vomiting, and unwanted movement), and (5) intraoperative standard monitoring parameters — i.e.…”

Section: Methodsmentioning

confidence: 99%

Dexmedetomidine vs propofol as sedation for implantation of neurostimulators: A single‐center single‐blinded randomized controlled trial

Bruggen

Ceuppens

Leliveld

et al. 2019

Acta Anaesthesiol Scand

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Background:During the lead implantation of most spinal cord neurostimulators, the patient has to be comfortable and without pain. However, the patient is expected to provide feedback during electrical mapping. Titrating sedatives and analgesics for this double goal can be challenging. In comparison with our standard sedative agent propofol, the pharmacological profile of dexmedetomidine is more conducive to produce arousable sedation. The latter, however, is associated with hemodynamic side effects. We investigated whether dexmedetomidine is preferable over propofol during neurostimulator implantation.Methods: This single-center single-blinded randomized controlled trial included 72 patients with an indication for a neurostimulator, randomized to sedation with either propofol (0.5 mg/kg for 10 minutes, followed by 2.0 mg/kg/h) or dexmedetomidine (1 μg/kg for 10 minutes, followed by 0.6 μg/kg/h). The primary outcome was patient satisfaction with the sedation. The secondary outcomes were patient's and operator's comfort, number of titration adjustments, standard intraoperative hemodynamic and respiratory parameters and side effects. Results: Data of 69 patients (dexmedetomidine n = 35; propofol n = 34) were analyzed. Those receiving dexmedetomidine were more satisfied with the sedation than those receiving propofol; i.e. with sedation delivery (median 100.0 vs 83.3, P < .01), procedural recall (median 95.8 vs 83.3, P = .03), and sedation side effects (median 90.0 vs 83.3, P = .01). Fewer changes in the dexmedetomidine titration were necessary to maintain arousable sedation. Over time, mean arterial pressure and heart rate were significantly lower in the dexmedetomidine group. Hemodynamic side effects were comparable across groups.Conclusions: Dexmedetomidine sedation resulted in higher patient satisfaction and allowed for better arousable sedation than sedation with propofol. Although differences in hemodynamic parameters were found between the groups, these differences were not regarded as clinically relevant. 1322 | ter BrUGGeN et al. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: ter Bruggen FFJA, Ceuppens C, Leliveld L, Stronks DL, Huygen FJPM. Dexmedetomidine vs propofol as sedation for implantation of neurostimulators: A single-center single-blinded randomized controlled trial. Acta

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“…10 Hasanin et al compared dexmedetomidine versus propofol for sedation during gastrointestinal endoscopy (GIE) in paediatric patients and concluded that dexmedetomidine sedation during GIE provides more respiratory safety & HR stability presenting itself as a suitable alternative agent especially for the relatively longer procedures. 28 In paediatric PSA dexmedetomidine had the unique advantage of noninterference with EEG results compared with other medications used as sedation options and also has analgesic properties, which propofol lacks Another advantage of dexmedetomidine in some…”

Section: Respiratory Effectsmentioning

confidence: 99%

Dexmedetomidine: An Ideal Drug for Procedural Sedation Outside Operation Theatre

Dinesh¹,

Aruna²,

Gurudatta³

2015

jemds

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Dexmedetomidine versus propofol for sedation during gastrointestinal endoscopy in pediatric patients

Cited by 19 publications

References 18 publications

Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review

Dexmedetomidine vs propofol as sedation for implantation of neurostimulators: A single‐center single‐blinded randomized controlled trial

Dexmedetomidine: An Ideal Drug for Procedural Sedation Outside Operation Theatre

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