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Article: Intranasal Dexmedetomidine In Combination With Patient-controlled Sedation During Upper Gastrointestinal Endoscopy: A Randomised Trial

TitleIntranasal Dexmedetomidine In Combination With Patient-controlled Sedation During Upper Gastrointestinal Endoscopy: A Randomised Trial
Authors
Issue Date2015
PublisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AAS
Citation
Acta Anaesthesiologica Scandinavica, 2015, v. 59 n. 2, p. 215-223 How to Cite?
AbstractBACKGROUND: Sedation using intranasal dexmedetomidine is a convenient and well-tolerated technique. This study evaluated the sedative efficacy of intranasal dexmedetomidine in combination with patient-controlled sedation (PCS) for upper gastrointestinal endoscopy. METHODS: In this double-blind, randomised, controlled trial, 50 patients received either intranasal dexmedetomidine 1.5 μg/kg (dexmedetomidine group) or intranasal saline (placebo group) 1 h before the procedure. PCS with propofol and alfentanil was provided for rescue sedation. Additional sedative consumption, perioperative sedation scores using Observer's Assessment of Alertness/Sedation (OAA/S) scale, recovery, vital signs, adverse events and patient satisfaction were assessed. RESULTS: Total consumption of PCS propofol and alfentanil was significantly less in the dexmedetomidine than placebo group with a mean difference of -13.8 mg propofol (95% confidence interval -27.3 to -0.3) and -34.5 μg alfentanil (95% confidence interval -68.2 to -0.7) at the completion of the procedure (P = 0.044). Weighted areas under the curve (AUCw ) of OAA/S scores were significantly lower in the dexmedetomidine group before, during and after procedures (P < 0.001, P = 0.024 and P = 0.041 respectively). AUCw of heart rate and systolic blood pressure were also significantly lower during the procedure (P = 0.007 and P = 0.022 respectively) with dexmedetomidine. There was no difference in recovery, side effects or satisfaction. CONCLUSION: Intranasal dexmedetomidine with PCS propofol and alfentanil confers deeper perioperative clinical sedation with significantly less use of additional sedatives during upper gastrointestinal endoscopy. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/210680
ISSN
2015 Impact Factor: 2.049
2015 SCImago Journal Rankings: 1.020

 

DC FieldValueLanguage
dc.contributor.authorCheung, CW-
dc.contributor.authorQIU, Q-
dc.contributor.authorLiu, JTC-
dc.contributor.authorChu, KM-
dc.contributor.authorIrwin, MG-
dc.date.accessioned2015-06-23T05:46:10Z-
dc.date.available2015-06-23T05:46:10Z-
dc.date.issued2015-
dc.identifier.citationActa Anaesthesiologica Scandinavica, 2015, v. 59 n. 2, p. 215-223-
dc.identifier.issn0001-5172-
dc.identifier.urihttp://hdl.handle.net/10722/210680-
dc.description.abstractBACKGROUND: Sedation using intranasal dexmedetomidine is a convenient and well-tolerated technique. This study evaluated the sedative efficacy of intranasal dexmedetomidine in combination with patient-controlled sedation (PCS) for upper gastrointestinal endoscopy. METHODS: In this double-blind, randomised, controlled trial, 50 patients received either intranasal dexmedetomidine 1.5 μg/kg (dexmedetomidine group) or intranasal saline (placebo group) 1 h before the procedure. PCS with propofol and alfentanil was provided for rescue sedation. Additional sedative consumption, perioperative sedation scores using Observer's Assessment of Alertness/Sedation (OAA/S) scale, recovery, vital signs, adverse events and patient satisfaction were assessed. RESULTS: Total consumption of PCS propofol and alfentanil was significantly less in the dexmedetomidine than placebo group with a mean difference of -13.8 mg propofol (95% confidence interval -27.3 to -0.3) and -34.5 μg alfentanil (95% confidence interval -68.2 to -0.7) at the completion of the procedure (P = 0.044). Weighted areas under the curve (AUCw ) of OAA/S scores were significantly lower in the dexmedetomidine group before, during and after procedures (P < 0.001, P = 0.024 and P = 0.041 respectively). AUCw of heart rate and systolic blood pressure were also significantly lower during the procedure (P = 0.007 and P = 0.022 respectively) with dexmedetomidine. There was no difference in recovery, side effects or satisfaction. CONCLUSION: Intranasal dexmedetomidine with PCS propofol and alfentanil confers deeper perioperative clinical sedation with significantly less use of additional sedatives during upper gastrointestinal endoscopy. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. -
dc.languageeng-
dc.publisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AAS-
dc.relation.ispartofActa Anaesthesiologica Scandinavica-
dc.rightsThe definitive version is available at www.blackwell-synergy.com-
dc.titleIntranasal Dexmedetomidine In Combination With Patient-controlled Sedation During Upper Gastrointestinal Endoscopy: A Randomised Trial-
dc.typeArticle-
dc.identifier.emailCheung, CW: cheucw@hku.hk-
dc.identifier.emailLiu, JTC: liutc909@hku.hk-
dc.identifier.emailChu, KM: chukm@hkucc.hku.hk-
dc.identifier.emailIrwin, MG: mgirwin@hku.hk-
dc.identifier.authorityCheung, CW=rp00244-
dc.identifier.authorityChu, KM=rp00435-
dc.identifier.authorityIrwin, MG=rp00390-
dc.identifier.doi10.1111/aas.12445-
dc.identifier.pmid25471688-
dc.identifier.hkuros243799-
dc.identifier.volume59-
dc.identifier.issue2-
dc.identifier.spage215-
dc.identifier.epage223-
dc.publisher.placeDenmark-

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