The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study

Abstract

The aim of the present prospective, randomized study was to investigate and compare the safety and efficacy of dexmedetomidine versus midazolam in providing sedation for gastroscopy. A total of 50 adult patients (25 patients receiving dexmedetomidine and 25 patients receiving midazolam), 18 to 60 years of age, and rated I and II on the American Society of Anesthesiologists physical status classification system were included. A brief questionnaire was used to collect demographic data; patients were asked to rate anxiety, satisfaction with care to date and expected discomfort on a visual analogue scale. The following parameters were measured continuously and recorded every minute: heart rate, mean arterial pressure, hemoglobin oxygen saturation and respiratory rate. The two groups were similar with regard to age, body mass index, sex, education, duration of endoscopy, and ethanol or tobacco use. After the procedure, full recovery time, mean arterial pressure, heart rate, respiratory rate and hemoglobin oxygen saturation levels were similar in both groups. Both groups also had low levels of perceived procedural gagging, discomfort and anxiety scores (P > 0.05), and high satisfaction levels (90.1+/-3.0 for dexmedetomidine versus 84.9+/-4.5 for midazolam; P > 0.05). Retching and endoscopist satisfaction were significantly different in patients receiving dexmedetomidine versus those receiving midazolam (88.8+/-6.5 versus 73.5+/-16.4, P < 0.05; and 20.6+/-4.4 versus 45.2+/-6.0; P < 0.001). In the midazolam group, the number of patients who had adverse effects was higher than the dexmedetomidine group (P < 0.05). As a result, dexmedetomidine performed as effectively and safely as midazolam when used as a sedative in upper gastroscopy; it was superior to midazolam with regard to retching, rate of side effects and endoscopist satisfaction. It was concluded that dexmedetomidine may be a good alternative to midazolam to sedate patients for upper endoscopy.

Study of KETODEX; Combination of Dexmedetomidine and Ketamine in Upper Gastrointestinal Scopy in Adults: Observational Study

“…Retching was found to be significantly lower and endoscopists satisfaction was higher. Decreasing of retching reflex may be due to its sympatholytic and vagomimetic effects of dexmedetomidine .The findings of our study were similar to the study of Yavuz Demiraran,Esin Korkut and et al (2005)(2006) 4 who did a prospective randomised study to compare efficacy of dexmedetomidine versus midazolam used for sedation during upper endoscopy .Hemodynamic parameters were similar in both groups High satisfaction levels were seen in both groups The anxiety score after the procedure was lower in patients receiving dexmedetomidine than those receiving midazolam Endoscopist satisfaction on sedation of patients was significantly higher in the patients receiving dexmedetomidine than those receiving midazolam Hence it was concluded that ,Dexmedetomidine being safe and effective, seems to be a good alternative to midazolam for sedation of patients during upper endoscopy. In our study 5 cases experienced gagging and hiccup,10 cases has increased salivation which was managed by suctioning and positioning the patient in lateral position .No other active intervention was required One case had vomiting., during the procedure and required additional dose of ketamine.…”

A prospective randomized double blind study to compare dexmedetomidine and midazolam in ear nose and throat surgery for monitored anesthesia care

“…14,15 Other studies have also reported better satisfaction scores with dexmedetomidine. 9,11,16,17 However, Zeyneloglu et al have reported better satisfaction scores with midazolam-fentanyl combination as compared to dexmedetomidine in extracorporeal shock wave lithotripsy (ESWL) when used alone. 18 The authors also concluded that probably it was not effective as a sole agent in ESWL.…”

Conscious Sedation for Endoscopic Retrograde Cholangiopancreatography: Dexmedetomidine Versus Midazolam

“…It is advisable that the protective reflexes are not suppressed and that the surgeon can work comfortably. Therefore, a sufficient dose of a conscious sedation medication should be administered, and monitoring methods should be performed [11]. In our study, we ensured that the patients in each group were motionless but sufficiently conscious to cooperate.…”