Application of Alfentanil Combined With Dexmedetomidine for Conscious Sedation of Patients During Transesophageal Echocardiography Examination.

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-01-30 DOI:10.1053/j.jvca.2025.01.032

Yushan Huang, Xiang Zhao, Jiagao Wang, Zelong Zhuang, Bin Xiao, RanRan

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引用次数: 0

Abstract

Objectives: To investigate the efficacy and safety of combining alfentanil with dexmedetomidine for conscious sedation in outpatients undergoing transesophageal echocardiography (TEE).

Design: Prospective, randomized, double-blind clinical trial.

Setting: University-affiliated teaching hospital.

Participants: We recruited 80 patients scheduled to undergo transesophageal echocardiography examinations from May 2023 to July 2023.

Interventions: Eighty patients were randomly assigned into 2 groups, namely, the alfentanil + dexmedetomidine (AD) group (n = 40) and the oropharyngeal topical anesthesia with dyclonine + midazolam + dexmedetomidine (MD) group (n = 40).

Measurements and main results: Suppression of the patient's pharyngeal reflexes was assessed, and the hemodynamic parameters, along with the incidence of intraoperative adverse events, were also documented. The primary outcome was the initial sedation success rate, defined as achieving a pharyngeal reflex grade of less than 3, no excessive sedation (Ramsay sedation scores >4), and no serious adverse effects. This rate was significantly higher in the AD group (85%) compared with the MD group (35%) (p < .001). Compared with the MD group (47.5%), the incidence of hypotension in AD group (25.0%) decreased significantly (p < .05). Although the incidence of respiratory depression in AD group (42.5%) was higher than that in MD group (15.0%) (p < .01), no hypoxia and asphyxia occurred in either group. The recovery time of AD group (626.25 ± 295.80) was significantly shorter than that of MD group (768.33 ± 310.43) (p < .05). No serious complications occurred in either group.

Conclusions: Intravenous alfentanil combined with dexmedetomidine effectively inhibits pharyngeal reflexes and demonstrates a favorable safety profile, with fewer incidents of hypotension but a higher incidence of manageable respiratory depression compared with the MD protocol.

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来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.