Dexmedetomidine in gastrointestinal endoscopic procedures

Amornyotin, Somchai

doi:10.5313/wja.v5.i1.1

Cited by 7 publications

(8 citation statements)

References 53 publications

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“…According to previously published trials, all patients received sufentanil (0.1 μg/kg) and propofol (1 to 2 mg/kg) for anesthesia induction based on ideal body weight [ 6 ]. In the DEX group, the intravenous loading dose of dexmedetomidine (Yangtze River, China) was set at 0.5 μg/kg at the start of anesthesia induction and loading for 10 min.…”

Section: Methodsmentioning

confidence: 99%

“…Unlike propofol, dexmedetomidine provides sedation with the respiratory drive preserved even at a loading dose [ 5 ]. Many studies have evaluated the effect of dexmedetomidine and propofol on sedation for gastrointestinal endoscopic procedures [ 6 , 7 ]. Mukhopadhyay et al found dexmedetomidine could reduce propofol requirement and provide a more stable level of sedation during ERCP procedure [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of single loading dose of dexmedetomidine combined with propofol for deep sedation of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients: a prospective randomized study

Chen

Sun

et al. 2022

BMC Anesthesiol

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Background Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic procedure and requires deep sedation. Deep sedation with dexmedetomidine for the respiratory drive preserved has become popular in recent years. However, the use of dexmedetomidine in elderly patients is controversial because its adverse events are more common. The objective of this study was to investigate the effectiveness of a single loading dose of dexmedetomidine combined with propofol for deep sedation of ERCP in elderly patients. Methods In this prospective randomized trial, 49 elderly patients undergoing ERCP were randomly allocated to the dexmedetomidine (DEX) or propofol (PRO) groups. The single loading dose of dexmedetomidine was set at 0.5 μg/kg at the start of anesthesia induction and loading for 10 min. The primary outcome was the cumulative dose of propofol. Secondary outcomes included time to awake, the frequency of airway interventions, and hemodynamics. Results The intraoperative cumulative dose of propofol was lower in the DEX group (111.0 ± 12.6 μg/kg/min) than the PRO group (143.7 ± 23.4 μg/kg/min) (P < 0.001). There was no statistically significant difference in the time to awake between the two groups. The incidence of artificial airway interventions and hypotension in the PRO group (36%, 60%) were significantly higher than those in the DEX group (4.2%, 16.7%) (P = 0.011, P = 0.003, respectively). In addition, the occurrence of bradycardia increased significantly in the DEX group (58.3%) compared with the PRO group (12%) (P < 0.001). Conclusions The single loading dose of dexmedetomidine combined with propofol can reduce propofol consumption and artificial airway intervention and provide better hemodynamic stability than propofol for deep sedation in elderly patients during ERCP. Trial registration www.chictr.org.cn (Registration number ChiCTR1900028069, Registration date 10/12/2019).

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of single loading dose of dexmedetomidine combined with propofol for deep sedation of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients: a prospective randomized study

Chen

Sun

et al. 2022

BMC Anesthesiol

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“…In addition, it decreases the stress-induced sympathetic response, protects the heart from myocardial ischemia, and has few side effects on the respiratory system. It is a medication of choice in conscious sedation because of these favorable benefits (5) . Dexmedetomidine has a distribution half-life of 6 minutes in people at doses of 0.2-0.7 mcg/kg/h intravenous infusion, indicating that it is rapidly dispersed and has a 2-hour elimination halflife.…”

Section: Introductionmentioning

confidence: 99%

Propofol versus combined propofol &Dexmedetomidine for conscious sedation in colonoscopy

Lashin

Eldesoky

Kasim

et al. 2022

Azhar International Journal of Pharmaceutical and Medical Scien

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Colonoscopy is an endoscopic procedure that examines the mucosa of the large intestine and distal terminal ileum for histopathological sampling and therapeutic procedures. Aim of the work: Comparing propofol & dexmedetomidine effects as conscious sedation in colonoscopy. Methods: Forty patients of both sexes candidates for colonoscopy were randomized to (D group & P group) each one included 20 patients: D Group: Dexmedetomidine was given as an initial loading dosage of 1 µg/kg i.v over ten minutes then received propofol 0.5mg/kg, then a continuous I.V. dexmedetomidine infusion (0.2-0.8) µg/kg/h was started until the procedure completed. P Group: The intravenous loading dose of propofol 2 mg/kg was given, then a continuous infusion of propofol 25-100 µg/kg/min was started until the procedure was completed. Results: The level of sedation was assessed using the Ramsay Sedation Score (RSS) showed a significant increase in the P group (2-2) compared to the D group activity (1-2) throughout 1-hour post-operatively. After 5 min of the procedure heart rate significantly decreased in group D then it became non-significant during the remaining time. The oxygen saturation % values showed a significant reduction in the P group (mean 95.45 ± 2.70) at 5 min of the procedure then it became non-significant during all remaining time. Although Bradycardia was more significantly higher in the D group, hypotension and respiratory complications were more significant higher in the P group. Also, the endoscopist was satisfied in the D group. Conclusion: In patients undergoing colonoscopy, dexmedetomidine combined with a low dose of propofol resulted in greater conscious sedation and adequate endoscopist satisfaction than propofol alone.

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“…The most common adverse effects associated with its use for procedural sedation are hypotension and bradycardia. However, dexmedetomidine as the sole agent has not been similarly successful for some invasive procedures [3].…”

Section: Introductionmentioning

confidence: 99%

Use of a combination of ketamine and dexmedetomidine (Ketodex) in different clinical cases

Amornyotin¹

2020

J Addict Med Ther Sci

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Ketamine is a dissociative anesthetic agent and is stable at room temperature. It works on thalamocortical and limbic N-methyl-D-aspartate (NMDA) receptors [2]. Ketamine stimulates the cardiorespiratory systems. It causes an increase in cerebral blood fl ow, intracranial pressure and cerebral metabolic rate. It should be avoided in the patients with ischemic heart disease, hypertension and raised intraocular pressures. However, ketamine produces unpleasant psychological effects including hallucinations, nightmares and emergence reactions.

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Dexmedetomidine in gastrointestinal endoscopic procedures

Cited by 7 publications

References 53 publications

Effectiveness of single loading dose of dexmedetomidine combined with propofol for deep sedation of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients: a prospective randomized study

Effectiveness of single loading dose of dexmedetomidine combined with propofol for deep sedation of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients: a prospective randomized study

Propofol versus combined propofol &Dexmedetomidine for conscious sedation in colonoscopy

Use of a combination of ketamine and dexmedetomidine (Ketodex) in different clinical cases

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