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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.

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