Comparison of the Effectiveness and Safety Between Intravenous Dexmedetomidine With Fentanyl Versus Intravenous Propofol With Fentanyl for Sedation in Diagnostic Upper Gastrointestinal Endoscopy

Abstract

Objective: The aim of this study was to compare the effectiveness and safety of intravenous dexmedetomidine with fentanyl versus intravenous propofol with fentanyl for sedation in diagnostic upper gastrointestinal (GI) endoscopy. Methods: 50 patients of ASA grade I, II, or III scheduled for GI endoscopy were randomly divided into two groups of 25 patients each. Group D received intravenous fentanyl and intravenous dexmedetomidine, and Group P received intravenous fentanyl and intravenous propofol. Hemodynamic variables, level of sedation using the Ramsay sedation score (RSS), patient satisfaction, and surgeon satisfaction using the visual analog scale (VAS) were recorded. Results: There was no significant difference in the demographic parameters (age, gender, weight, ASA class) between the two groups. The mean time to reach RSS 4–5 was less in group P (27.60±6.44 s) when compared to group D (521.56±39.13 sec; p=0.0004). Patient satisfaction was higher in group D (7.9±0.7) as compared to group P (7.3±0.8; p=0.0069). While there was no significant difference in the surgeon’s satisfaction regarding difficulty during the procedure (8.3±0.9 and 7.9±1.3 in group D and group P, respectively; p=0.2120). Conclusion: Dexmedetomidine with fentanyl resulted in a better hemodynamic profile, respiratory profile, patient satisfaction, and quicker recovery than propofol with fentanyl. Whereas propofol with fentanyl provided quicker onset and more efficient sedation compared to dexmedetomidine with fentanyl.