eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2020
vol. 15
 
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abstract:
Original paper

Dexmedetomidine or midazolam in combination with propofol for sedation in endoscopic retrograde cholangiopancreatography: a randomized double blind prospective study

Senem Koruk
1
,
Irfan Koruk
2
,
Ayse Mizrak Arslan
3
,
Murat Bilgi
4
,
Rauf Gul
5
,
Semsettin Bozgeyik
6

1.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
2.
Department of Gastroenterology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
3.
Department of Anesthesiology and Reanimation, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
4.
Department of Anesthesiology and Reanimation, Abant Izzet Baysal University, Bolu, Turkey
5.
Department of Anesthesiology and Reanimation, NCR International Hospital, Gaziantep, Turkey
6.
Department of Anesthesiology and Reanimation, Defa Life Hospital, Gaziantep, Turkey
Videosurgery Miniinv 2020; 15 (3): 526–532
Online publish date: 2020/05/10
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Introduction
Interventional endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), often require sedation during the procedure. The most commonly used drugs for this purpose are midazolam and propofol, which are used as sedative and hypnotic agents with minimal analgesic potential.

Aim
To compare the analgesic sedative effects of midazolam-propofol and dexmedetomidine-propofol combinations and their influence on hemodynamic and respiratory variables in patients undergoing ERCP.

Material and methods
Forty adult patients aged 20-78 and undergoing ERCP were randomized to two groups. Patients were premedicated with midazolam (0.05 mg/kg 10 min before the procedure) in group M and with dexmedetomidine (1 µg/kg for 10 min) in group D. Propofol was used for maintenance. The sedation level was monitored using the bispectral index (BIS) to maintain a score between 70 and 80. Hemodynamic and respiratory variables, recovery time and adverse events were recorded.

Results
The hemodynamic and respiratory variables were similar in both groups. Total propofol consumption was significantly lower in the dexmedetomidine group (208.5 ±80.0 vs. 154.5 ±66.7 mg; p = 0.011). The recovery period was shorter in group D (time to achieve the Aldrete score 9 was 9.4 ±2.1 vs. 6.6 ±1.1 min; p < 0.001). Changes in hemodynamic and respiratory variables and adverse events were not different between the two groups.

Conclusions
We found a shorter recovery time and comparable sedative and adverse effects with the dexmedetomidine-propofol combination compared with the midazolam-propofol combination. Dexmedetomidine in combination with propofol may be a safe and useful alternative for sedation for ERCP patients.

keywords:

dexmedetomidine, sedation, bispectral index, endoscopic retrograde cholangiopancreatography, recovery time

  
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