A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room

BACKGROUND: Patients may experience anxiety, discomfort, and pain during endoscopy, which cannot be tolerated without sedative drugs. OBJECTIVES: This study aimed to compare the sedative effects of dexmedetomidine and midazolam on patients undergoing endosonography outside the operating room. METHOD...

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Autores principales: Ghomeishi, Ali, Akhondzadeh, Reza, Baghbanian, Reza, Mahmoudi, Kamran, Bakhtiari, Nima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Brieflands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664169/
https://www.ncbi.nlm.nih.gov/pubmed/38021337
http://dx.doi.org/10.5812/aapm-109721
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author Ghomeishi, Ali
Akhondzadeh, Reza
Baghbanian, Reza
Mahmoudi, Kamran
Bakhtiari, Nima
author_facet Ghomeishi, Ali
Akhondzadeh, Reza
Baghbanian, Reza
Mahmoudi, Kamran
Bakhtiari, Nima
author_sort Ghomeishi, Ali
collection PubMed
description BACKGROUND: Patients may experience anxiety, discomfort, and pain during endoscopy, which cannot be tolerated without sedative drugs. OBJECTIVES: This study aimed to compare the sedative effects of dexmedetomidine and midazolam on patients undergoing endosonography outside the operating room. METHODS: This randomized, double-blind clinical trial was conducted on 126 patients aged 18 - 65 years old with American Society of Anesthesiologists (ASA) physical status I - II undergoing elective endosonography. Patients were randomly divided into 2 groups. The dexmedetomidine group received dexmedetomidine (1 μg/kg) for 25 minutes with propofol (0.5 mg/kg) and fentanyl (1 μg/kg) at the start of the procedure. The midazolam group received midazolam (0.03 mg/kg) with propofol (0.5 mg/kg) and fentanyl (1 μg/kg). Heart rate, mean arterial pressure (MAP), and oxygen saturation (SpO(2)) were recorded before and 5, 10, and 15 minutes after starting the procedure. The Ramsay Sedation Scale (RSS) and the need for an additional dose of propofol were recorded during the procedure. The Numeric Pain Rating scale (Ambesh score) scores were recorded at the beginning, immediately after, and 1 hour after the procedure. Nausea and vomiting were assessed using the Visual Analogue Scale in cooperation with the patient. RESULTS: The dexmedetomidine group had significantly higher SpO(2) and RSS scores during sedation than the midazolam group (P = 0.02). Overall, specialist satisfaction was higher in the dexmedetomidine group than in the midazolam group. There was no clinically significant difference in pain score and nausea and vomiting frequencies between the 2 groups. CONCLUSIONS: Dexmedetomidine is more effective than midazolam for sedation during gastrointestinal endosonography.
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spelling pubmed-106641692023-05-01 A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room Ghomeishi, Ali Akhondzadeh, Reza Baghbanian, Reza Mahmoudi, Kamran Bakhtiari, Nima Anesth Pain Med Research Article BACKGROUND: Patients may experience anxiety, discomfort, and pain during endoscopy, which cannot be tolerated without sedative drugs. OBJECTIVES: This study aimed to compare the sedative effects of dexmedetomidine and midazolam on patients undergoing endosonography outside the operating room. METHODS: This randomized, double-blind clinical trial was conducted on 126 patients aged 18 - 65 years old with American Society of Anesthesiologists (ASA) physical status I - II undergoing elective endosonography. Patients were randomly divided into 2 groups. The dexmedetomidine group received dexmedetomidine (1 μg/kg) for 25 minutes with propofol (0.5 mg/kg) and fentanyl (1 μg/kg) at the start of the procedure. The midazolam group received midazolam (0.03 mg/kg) with propofol (0.5 mg/kg) and fentanyl (1 μg/kg). Heart rate, mean arterial pressure (MAP), and oxygen saturation (SpO(2)) were recorded before and 5, 10, and 15 minutes after starting the procedure. The Ramsay Sedation Scale (RSS) and the need for an additional dose of propofol were recorded during the procedure. The Numeric Pain Rating scale (Ambesh score) scores were recorded at the beginning, immediately after, and 1 hour after the procedure. Nausea and vomiting were assessed using the Visual Analogue Scale in cooperation with the patient. RESULTS: The dexmedetomidine group had significantly higher SpO(2) and RSS scores during sedation than the midazolam group (P = 0.02). Overall, specialist satisfaction was higher in the dexmedetomidine group than in the midazolam group. There was no clinically significant difference in pain score and nausea and vomiting frequencies between the 2 groups. CONCLUSIONS: Dexmedetomidine is more effective than midazolam for sedation during gastrointestinal endosonography. Brieflands 2023-05-01 /pmc/articles/PMC10664169/ /pubmed/38021337 http://dx.doi.org/10.5812/aapm-109721 Text en Copyright © 2023, Ghomeishi et al. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Research Article
Ghomeishi, Ali
Akhondzadeh, Reza
Baghbanian, Reza
Mahmoudi, Kamran
Bakhtiari, Nima
A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title_full A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title_fullStr A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title_full_unstemmed A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title_short A Comparison of the Sedative Effect of Dexmedetomidine and Midazolam on Patients Undergoing Gastrointestinal Endosonography Outside the Operating Room
title_sort comparison of the sedative effect of dexmedetomidine and midazolam on patients undergoing gastrointestinal endosonography outside the operating room
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664169/
https://www.ncbi.nlm.nih.gov/pubmed/38021337
http://dx.doi.org/10.5812/aapm-109721
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