Dexmedetomidine provides less body motion and respiratory depression during sedation in double-balloon enteroscopy than midazolam

Abstract

Objectives:Patients undergoing double-balloon enteroscopy require sedatives such as midazolam; however, patient’s body motion often hampers the outcome of double-balloon enteroscopy. Recently, dexmedetomidine has been used for endoscopic sedation and was reported to effectively reduce body motion. This study aimed to evaluate the efficacy and safety of sedation with dexmedetomidine in double-balloon enteroscopy (UMIN ID000015785).Methods:A prospective, observational study was conducted in 81 patients who underwent 111 double-balloon enteroscopy from July to December 2015 (dexmedetomidine group). The medical records of 112 patients who underwent 166 double-balloon enteroscopy with midazolam and pentazocine sedation from January 1 to October 31, 2014, were used for comparison (midazolam group). After propensity score matching, 182 double-balloon enteroscopy (91 double-balloon enteroscopy for each group) were analyzed.Results:There were 13 cases (11.7%) with body movements in the dexmedetomidine group. Comparison of the two groups matched by propensity score showed that the dexmedetomidine group had less body movement (12.1% vs 34.1%, p = 0.001) and less respiratory depression (50.5% vs 68.1%, p = 0.023). Hypotension (8.8% vs 4.4%, p = 0.232) and bradycardia (2.2% vs 0%, p = 0.497) were not significantly different in the two groups.Conclusion:Using dexmedetomidine for conscious sedation can reduce body motion and respiratory depression compared to our previous records.

Endoscopic Hematoma Evacuation for Acute Subdural Hematoma in the Elderly: A Preliminary Study

“…We have used dexmedetomidine and pentazocine as anesthesia for endoscopic surgery for ASDH. Our results show that our anesthesia can suppress body motion and maintain respiration without intubation for about 95 minutes in line with findings from Oshima et al 15 Moreover, our anesthesia is safe for elderly patients without intraoperative or postoperative systemic complications.…”

“…Hence, it is crucial to perform the surgery under safe and definite sedation and analgesia. Oshima et al 15 have reported that using dexmedetomidine for conscious sedation in enteroscopy can reduce body motion and respiratory depression more effectively than midazolam. We have used dexmedetomidine and pentazocine as anesthesia for endoscopic surgery for ASDH.…”

Effects of Dexmedetomidine on Perioperative Serum Potassium and Postoperative Rehabilitation of Patients Undergoing Radical Resection of Gastrointestinal Malignancy

“…A transient increase in blood pressure in a short period of time after dexmedetomidine use may be associated with its direct activation on alpha 2 -adrenergic receptors on vascular smooth muscle cells and leading to vasoconstriction, after which blood pressure drops with dexmedetomidine acting on the locus ceruleus, inhibiting the sympathetic nervous system excitation and also increasing the vagal excitability [13,14]. In the current study, it is noteworthy that MAP was signi cantly higher in group D 1 after dexmedetomidine loading dose nish compared to the control group, whereas there were no signi cant changes in MAP in group D 2 at this timepoint, which may be related to the higher basic MAP in the group D 1 than group D 2 .…”

Accuracy of carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography using double-balloon endoscopy

“…Analgesics were additionally and repeatedly used for 7.5 mg as necessary, based on the consciousness and pain of the patient during the procedure. Dexmedetomidine (loaded at 6 μg/kg/h for 10 min and maintained at 0.4 μg/kg/h) was administered concomitantly in patients in whom sufficient sedation was not achieved using diazepam and pentazocine[ 10 ]. General anesthesia was used in child and adolescent patients.…”