Effects of Propofol, Dexmedetomidine, or Ketofol on Respiratory and Hemodynamic Profiles in Cardiac Patients Undergoing Transesophageal Echocardiography: A Prospective Randomized Study

Mourad, Mona Blough El; Shaaban, Aliaa Elsaid; Sharkawy, Sara Ibrahim El; Afandy, Mohamed Elsayed

doi:10.1053/j.jvca.2020.11.013

Cited by 10 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the same study, better respiratory parameters were obtained in the patients administered ketamin and dexmedetomidine than in those who received propofol. The best hemodynamic stability was obtained in the ketamin group (3). Similarly, in another study that compared propofol and dexmedetomidine, the onset of sedation was more rapid in the propofol group but satisfaction with the anaesthesia was higher in the patients administered dexmedetomidine, together with more stable hemodynamic parameters and a shorter time to recovery (4).…”

Section: Discussionmentioning

confidence: 90%

“…Studies that have compared sedative anaesthesia selections applied for TEE have provided different results (1,(3)(4)(5)(6). The majority of these studies have compared propofol and other agents and have included a limited number of patients (3,4). Only one study evaluated sedation applied with propofol and midazolam with 30 patients in each group (1).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy and safety of conscious sedation applied with midazolam in the transesophageal echocardiography procedure

Harbalıoğlu

Yıldırım

Koca

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective The aim of this study was to compare the anaesthesia parameters, procedure duration, and the effect on hemodynamics and clinical parameters during the procedure in patients undergoing transesophageal echocardiography (TEE) with conscious sedation applied with midazolam or propofol. Methods This cross-sectional study included 401 patients (198 males, 203 females, mean age 52.9 ± 14.8 years) applied with TEE in our clinic. The demographic, clinical and laboratory parameters of the patients were recorded before the procedure. A record was made of pre-procedure ASA score and basal SaO2, the time to sedation to TEE, TEE duration, time to recovery, and during the procedure the minimum SaO2, the need for non-invasive mechanical ventilation (NIMV), the change in systolic and diastolic blood pressure (SBP and DBP), O2 saturation change, and pulse change. The data were compared between the patients in two groups according to the conscious sedation agent used; midazolam and propofol. Results The demographic, clinical, and laboratory data of the midazolam and propofol groups were found to be similar (p > 0.05 for each). The procedure duration, and time to recovery were determined to be significantly shorter in the midazolam group than in the propofol group, and the time to onset of the sedation effect was significantly longer (p < 0.05 for each). Of the respiratory parameters, the minimum SaO2 during the procedure, the absolute change in O2 saturation, and the need for NIMV were determined to be significantly lower in the midazolam group (p < 0.05 for each). The absolute pulse and change in SBP and DBP values were found to be significantly higher in the propofol group (p < 0.05 for each). Conclusions The study results demonstrated that conscious sedation applied with midazolam during TEE can be applied with a shorter procedure duration and better hemodynamic and clinical results compared to sedation with propofol.

show abstract

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of conscious sedation applied with midazolam in the transesophageal echocardiography procedure

Harbalıoğlu

Yıldırım

Koca

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…17 In this study, was observed that propofol had a higher satisfaction score than dexmedetomidine and caused less hemodynamic alterations. 14 In the study of Toman et al, it was observed that propofol provided faster sedation than the combination of midazolam and midazolam-alfentanil, the depth of sedation was better and the length of hospital stay was shortened. 18 In some studies conducted with different diagnostic procedures such as colonoscopy and endoscopy, it has been shown that the application of deep sedation with propofol provided similar physician and patient satisfaction when midazolam was applied in combination with opioid.…”

Section: Discussionmentioning

confidence: 99%

“…Although propofol is mostly preferred for deep sedation during TEE, there are studies where it was also used for conscious sedation. [14][15][16] Although, it is used at lower doses in conscious sedation, respiratory depression due to propofol may still occur. 17 In this study, was observed that propofol had a higher satisfaction score than dexmedetomidine and caused less hemodynamic alterations.…”

Section: Discussionmentioning

confidence: 99%

The superiority of midazolam-pethidine combination in three different anesthetic methods applied in conscious sedation during transesophageal echocardiography procedure

Ak¹,

Ozsahin²,

Yeşiltaş³

et al. 2022

Asian J Med Sci

View full text Add to dashboard Cite

Background: During the transesophageal echocardiography (TEE) procedure, as in many other diagnostic semi-invasive applications, moderate sedation is preferred over deep sedation. Rarely, patients who cannot tolerate moderate sedation may require deep sedation when difficulties are encountered during TEE probe insertion. Although many different methods have been tried for the TEE procedure in clinical practice, the most appropriate sedation method is still controversial. Aims and Objectives: We aimed to evaluate the clinical effects of three different sedoanalgesia methods consisting of midazolam, propofol, and midazolam-pethidine combination protocols applied for conscious sedation in the patients undergoing a TEE procedure, and to evaluate the patient and doctor satisfaction during the procedure. Materials and Methods: One-hundred twenty five patients who underwent TEE for diagnostic purposes in our hospital were included consecutively in our prospective randomized trial. The patients were divided into three groups as those who were administered midazolam (group M), propofol (group Pr), and midazolam-pethidine (group MPe) during the TEE procedure. Results: In the MPe group, both patient and doctor satisfaction were significantly higher than the two groups. The rate of difficulty in probe placement was lower in the Pr and MPe groups compared to the M group (P<0.05). Conclusion: In this study, it has been observed that conscious sedation with the combination of midazolam-pethidine was significantly advantageous in terms of patient and physician satisfaction compared to the use of only midazolam and only propofol.

show abstract

“…Quite a few studies have demonstrated that prolonging recovery time can reduce the incidence of EA after sevoflurane (32, 33). The advantage of propofol over dexmedetomidine and midazolam is the minor influence of awakening time or discharge time (34)(35)(36). Therefore, the balance between efficacy and rapid recovery or discharge from PACU should be considered while administering higher doses.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of propofol for the prevention of emergence agitation after sevoflurane anaesthesia in children: A meta-analysis

et al. 2022

View full text Add to dashboard Cite

BackgroundEmergence agitation (EA) is a common postoperative behavioral disorder, predominantly in pediatric patients, after sevoflurane general anesthesia. This study was aimed at assessing propofol's efficacy and clinical conditions established for preventing EA in children under sevoflurane anesthesia.MethodsRandomized controlled trials (RCTs) that comparatively investigated propofol and control treatment in terms of efficacy and safety on administration at the end of surgery and examinations to prevent EA in children under sevoflurane anesthesia were searched. The sources accessed included PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. Furthermore, manual searches were performed to identify studies; the last review was conducted on March 21, 2022. When the risk of bias assessment of trials was performed with the Cochrane Risk of Bias Tool, we calculated risk ratios (RRs) with 95% confidence intervals (CIs) for EA incidence and mean differences (MDs) with 95% CI for continuous data.ResultsWe included 12 RCTs with 1103 children. EA incidence (RR: 0.51, 95% CI: 0.39 to 0.67) and Pediatric Anesthesia Emergence Delirium scores (MD: −3.14, 95% CI: −4.37 to −1.92) were lower in the propofol group. Subgroup analyses showed lower EA incidences with 3 mg/kg propofol (RR: 0.22, 95% CI: 0.13 to 0.38) without extension of the PACU time (MD: 4.97, 95% CI: −0.84 to 10.78) in the laryngeal mask airway (LMA; RR: 0.52, 95% CI: 0.36 to 0.77) and spontaneous breathing (RR: 0.36, 95% CI: 0.21 to 0.62) groups.DiscussionWe confirmed that a prophylactic dose of propofol prevented EA and decreased its severity in children under sevoflurane anesthesia. Furthermore, several conditions such as 3 mg/kg propofol, LMA, and spontaneous breathing, potentially contributed to EA prevention. Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=274692, identifier: PROSPERO (No. CRD42021274692).

show abstract

Effects of Propofol, Dexmedetomidine, or Ketofol on Respiratory and Hemodynamic Profiles in Cardiac Patients Undergoing Transesophageal Echocardiography: A Prospective Randomized Study

Cited by 10 publications

References 35 publications

The efficacy and safety of conscious sedation applied with midazolam in the transesophageal echocardiography procedure

The efficacy and safety of conscious sedation applied with midazolam in the transesophageal echocardiography procedure

The superiority of midazolam-pethidine combination in three different anesthetic methods applied in conscious sedation during transesophageal echocardiography procedure

Efficacy of propofol for the prevention of emergence agitation after sevoflurane anaesthesia in children: A meta-analysis

Contact Info

Product

Resources

About