Propofol versus Dexmedetomidine for Sedation of Cancer Patients Undergoing Endoscopic Retrograde Cholangiopancreatography: Randomized Single-Blinded Controlled Study.

Q2 Medicine
Anesthesiology and Pain Medicine Pub Date : 2024-09-09 eCollection Date: 2024-08-01 DOI:10.5812/aapm-148512
Ahmed Mohamed Soliman, Yehya Mohamed Hamad, Abeer AbdElmonem Almaghraby, Ahmed Abdalla Mohamed, Shady Rady Abdallah
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引用次数: 0

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a primary diagnostic and therapeutic option for pancreaticobiliary pathologies.

Objectives: This study aimed to investigate the efficacy and safety of dexmedetomidine versus propofol during ERCP in cancer patients.

Methods: This randomized controlled single-blinded trial was conducted with 202 cancer patients aged 21 to 60 years, of both sexes, with a body mass index of 18.5 to 30 kg/m2, and classified as American Society of Anesthesiologists (ASA) class II - III, who were undergoing ERCP. The patients were randomly assigned to two equal groups. The Propofol Group (n = 101) received a loading dose of propofol (1 - 2 mg/kg over 30 seconds) followed by an infusion (0.05 - 0.1 mg/kg/hour). The Dexmedetomidine Group (n = 101) received a loading dose of dexmedetomidine (1 μg/kg over 10 minutes) followed by an infusion (0.2 - 0.7 μg/kg/hour). The maintenance dose was adjusted during the procedure based on vital signs, Bispectral Index (BIS), and oxygen saturation.

Results: The Dexmedetomidine group showed a significantly lower incidence of intra-procedural hypoxemic events (14.9% vs. 26.7%, P = 0.037) and a comparable incidence of hypotension (17.8% vs. 13.9%, P = 0.441). Dexmedetomidine also demonstrated significantly lower intraoperative pain scores according to the Facial Pain Score (P < 0.05), significantly lower postoperative Visual Analog Scale (VAS) scores (P < 0.05), and a lower frequency of postoperative nausea and vomiting (PONV) compared to the Propofol group. Additionally, there was a significantly higher frequency of endoscopist satisfaction in the Dexmedetomidine group compared to the Propofol group (P < 0.05).

Conclusions: Dexmedetomidine can be used as a safe and effective alternative to propofol for deep sedation of cancer patients undergoing ERCP. It is associated with a lower incidence of hypoxemic events, effective intraoperative sedation, quicker recovery, and superior analgesic effects both intraoperatively and postoperatively compared to propofol.

异丙酚与右美托咪定对内镜逆行胆管造影癌症患者的镇静作用:随机单盲对照研究。
背景:内镜逆行胰胆管造影(ERCP)是胰胆管病变的主要诊断和治疗选择。目的:本研究旨在探讨右美托咪定与异丙酚在癌症患者ERCP中的疗效和安全性。方法:本随机对照单盲试验纳入202例接受ERCP治疗的癌症患者,年龄21 ~ 60岁,男女皆可,体重指数18.5 ~ 30 kg/m2,美国麻醉学会(ASA) II ~ III类。患者被随机分为两组。异丙酚组(n = 101)给予异丙酚负荷剂量(1 ~ 2 mg/kg/ 30秒),然后静脉滴注(0.05 ~ 0.1 mg/kg/h)。右美托咪定组(n = 101)先给予右美托咪定负荷剂量(1 μg/kg/ 10min),然后静脉滴注(0.2 ~ 0.7 μg/kg/h)。在治疗过程中根据生命体征、双谱指数(BIS)和血氧饱和度调整维持剂量。结果:右美托咪定组术中低氧血症发生率(14.9% vs. 26.7%, P = 0.037)和低血压发生率(17.8% vs. 13.9%, P = 0.441)显著降低。与异丙酚组相比,右美托咪定组术中面部疼痛评分显著降低(P < 0.05),术后视觉模拟评分(VAS)显著降低(P < 0.05),术后恶心呕吐(PONV)发生率显著降低。此外,右美托咪定组的内镜医师满意度明显高于异丙酚组(P < 0.05)。结论:右美托咪定可作为一种安全有效的替代异丙酚用于肿瘤ERCP患者的深度镇静。与异丙酚相比,低氧血症发生率低,术中镇静效果好,恢复快,术中及术后镇痛效果好。
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来源期刊
Anesthesiology and Pain Medicine
Anesthesiology and Pain Medicine Medicine-Anesthesiology and Pain Medicine
CiteScore
4.60
自引率
0.00%
发文量
49
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