Dexmedetomidine versus midazolam for sedation in upper gastrointestinal endoscopy

J Int Med Res. 2014 Apr;42(2):516-22. doi: 10.1177/0300060513515437. Epub 2014 Feb 10.

Abstract

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 (SpO2), 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 = 30) experienced a significant decrease in MAP during sedation compared with pre-sedation values. Patients in the dexmedetomidine group (n = 30) had significantly higher SpO2 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.

Keywords: Dexmedetomidine; gastrointestinal endoscopy; sedation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics, Non-Narcotic / adverse effects
  • Analgesics, Non-Narcotic / therapeutic use
  • Anesthetics, Intravenous / adverse effects
  • Anesthetics, Intravenous / therapeutic use
  • Arterial Pressure / drug effects
  • Conscious Sedation*
  • Dexmedetomidine / adverse effects
  • Dexmedetomidine / therapeutic use*
  • Endoscopy, Gastrointestinal*
  • Female
  • Fentanyl / therapeutic use
  • Heart Rate / drug effects
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Midazolam / adverse effects
  • Midazolam / therapeutic use*
  • Middle Aged
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Analgesics, Non-Narcotic
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Dexmedetomidine
  • Midazolam
  • Fentanyl