A comparison of propofol vs. dexmedetomidine for sedation, haemodynamic control and satisfaction, during esophagogastroduodenoscopy under conscious sedation

作者：Wu Y^*; Zhang Y; Hu X; Qian C; Zhou Y; Xie J

来源：Journal of Clinical Pharmacy and Therapeutics, 2015, 40(4): 419-425.

DOI：10.1111/jcpt.12282

• conscious sedation
• dexmedetomidine
• endoscopy
• propofol

What is known and objectiveEsophagogastroduodenoscopy (EGD) is a common diagnostic procedure which requires sedation for most patients. We undertook a prospective, randomized, double-blinded study to compare the effect of propofol vs. dexmedetomidine on the sedation of outpatients during EGD.
MethodsPrior to the procedure, outpatients received either propofol at 06mg/kg, with additional doses of 10-20mg until the Observer's Assessment of Alertness/Sedation Scale (OAA/S) score reached 2-4, or dexmedetomidine at a loading dose of 1g/kg over a 10-min period followed by a 05g/kg/h infusion until the OAA/S score reached 2-4. Vital signs, sedation level, adverse events, patients' and endoscopist's satisfaction score, and an evaluation of the recovery time were assessed.
Results and discussionNegligible haemoglobin oxygen saturation (SpO(2)) and respiratory rate variations were observed in both groups, although respiratory depression occurred in two cases (59%) in the propofol group. Mean arterial pressure (MAP) in the propofol group decreased during the procedure compared with baseline (P<005) and was also lower in comparison with the dexmedetomidine group (P<005). Heart rate (HR) decreased after the loading dose in the dexmedetomidine group (P<005). More patients in the propofol group underwent deeper sedation at the beginning of the procedure (P<005), although the recovery time was comparable between the two groups (P>005). Three cases (91%) in the dexmedetomidine group were delayed because of dizziness, bradycardia and nausea. There was a higher satisfaction score among patients in the propofol group (P<005), although the endoscopist's satisfaction score was comparable between the two groups (P>005).
What is new and conclusionPropofol and dexmedetomidine provide a relatively satisfactory level of sedation without clinically notable adverse effects during EGD. In addition, patients preferred propofol administration for the deeper sedation and rapid recovery, and dexmedetomidine exhibited minimal adverse effects on respiratory function.

• 出版日期2015-8
• 单位安徽医科大学