Dexmedetomidine versus Fentanyl as Adjuvant to Propofol Total Intravenous Anesthesia during Endoscopic Retrograde Cholangial-Pancreatography Procedure

Abstract Background Various types of sedation and analgesia technique have been used during endoscopy procedures. Providing an adequate regimen of sedation/analgesia might be considered an art, influencing several aspects of endoscopic procedures: the quality of examination, the patient’s cooperatio...

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 2023-08, Vol.116 (Supplement_1)
Main Authors: Reyad, Mostafa Kamel, Anis, Sherif George, Mahran, Mostafa Gamaledin, Aguer, Nyanriak Thon
Format: Article
Language:English
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Summary:Abstract Background Various types of sedation and analgesia technique have been used during endoscopy procedures. Providing an adequate regimen of sedation/analgesia might be considered an art, influencing several aspects of endoscopic procedures: the quality of examination, the patient’s cooperation and the patient and physician’s satisfaction with sedation Objective To compare the effects of Dexmedetomidine/Propofol and Fentanyl/Propofol combination for conscious sedation in patients undergoing ERCP regarding hemodynamic changes, patients and endoscopists satisfaction. Patients and Methods Ninety four (94) ages 18-70 ASA ı-ıı were enrolled in this study. Patients were allocated randomly into two equal groups D/P and F/P groups. Patients received either Fentanyl 1 µg/kg or Dexmedetomidine 1 µg/kg for 10 min, followed by maintenance dose 0.2 µg to 0.5 µg/kg/min. combined with propofol 1 mg/kg IV and maintenance 3 mg/kg/h regimen. With requiring additional dose if sedation level did not reached. Conduct open airway technique was used while applying o through nasal cannula 3 L/min. (MAP, HR and SPO) were recorded before and after sedation procedures then every 10 min. till the end of procedure, recovery time, postoperative complications, patients and endoscopists were recorded. Results the intra procedure HR, and BP showed statistical significant differences between both groups throughout the procedure with lower value in group D/P (p = 0.042) while there were no statistical significance differences regarding MAP and SPO. During postoperative procedure BP and MAP was statistical significant lower in D/P group (p = 0.015). Post procedure recovery time was shorter in group D/P (p = 0.049), regarding PONV was higher in D/P compared to F/P (p = 0.03), both group were statistical significant satisfied. Conclusion In our study we concluded that Dexmedetomidine/ Propofol combination provided adequate sedation with hemodynamic and respiratory stability with accepted few side effects and a good satisfication scores for patients and endoscopists. It was a good competitive to standard sedative as Fentanyl/Propofol in moderate sedation during ERCP.
ISSN:1460-2725
1460-2393
DOI:10.1093/qjmed/hcad069.088