Dexmedetomidine in gastrointestinal endoscopic procedures

Table 2 The use of dexmedetomidine in a single agent technique for gastrointestinal endoscopic procedures

Ref.	Type of endoscopy	No. of patients	DEX group	Non-DEX group	Summary of findings
Samson et al[21]	EGD	90	DEX 1 mcg/kg followed by 0.5 mcg/kg per hour infusion iv	MDZ 0.04 mg/kg followed by an additional dose of 0.5 mg iv	Endoscopist satisfaction and recovery in DEX group was significantly better than in MDZ and PRO groups
Jiang et al[23]	EGD	40	DEX 0.8 mcg/kg iv	PRO 2.5 mg/kg iv	DEX could yield marked sedative effect, had antihypertensive effect and did not suppress respiration
Demiraran et al[22]	EGD	50	DEX 1 mcg/kg followed by 0.2 mcg/kg per hour infusion iv	MDZ 0.07 mg/kg (total dose 5 mg) iv	DEX was superior to MDZ with regard to retching, rate of adverse events and endoscopist satisfaction for EGD sedation
Sula et al[35]	Colonoscopy	231	DEX 1 mcg/kg iv	PRO 1.5 mg/kg and on demand bolus 0.4-0.5 mg/kg iv	Both regimens were effective and safe for sedation. PRO caused more desaturation, while DEX caused more hypotension
1Jalowiecki et al[38]	Colonoscopy	64	Group D: DEX 1 mcg/kg followed by 0.2 mcg/kg per hour infusion iv	Group P: 1 mg/kg of MEP with 0.05 mg/kg of MDZ iv, Group F: 0.1-0.2 mg of FEN iv on demand	There was a significantly greater decrease in heart rate and blood pressure in group D. Time to home readiness was the longest in group D
1Eldesuky Ali Hassan et al[48]	ERCP	50	Group D: DEX 1 mcg/kg followed by 0.5 mcg/kg per hour infusion iv	Group K: ketofol 1 mg/kg iv bolus followed by 50 mcg/kg per minute infusion iv	Time to achieve sedation score and total dose of rescue sedation were not significantly different. Patient and endoscopist satisfaction in group K was significantly higher than in group D
Kilic et al[40]	ERCP	50	Group D: DEX 1 mcg/kg followed by 0.2-0.7 mcg/kg per hour infusion iv	Group M: MDZ 0.04 mg/kg followed by an additional dose of 0.5 mg iv	DEX showed higher endoscopist satisfaction. Coughing, nausea and vomiting were observed in three patients in group M, but no patients in group D
Ceylan et al[41]	ERCP	50	Group D: DEX 1 mcg/kg followed by 0.2-0.7 mcg/kg per hour infusion iv	Group P: PRO 75 mcg/kg per hour followed by 12.5-100.0 mcg/kg per minute infusion iv	Blood pressure and heart rate values in group D were significantly lower than in group P. There were no significant differences in patient and endoscopist satisfaction
1Muller et al[52]	ERCP	26	Group D: DEX 1 mcg/kg followed by 0.2-0.5 mcg/kg per hour infusion iv	Group P: PRO (target plasma concentration 2-4 mcg/mL) with FEN 1 mcg/kg iv	DEX alone was not as effective as PRO combined with FEN. DEX was associated with greater hemodynamic instability and a prolonged recovery period
Eberl et al[55]	Esophageal intervention	64	DEX 1 mcg/kg (0.5 mcg/kg in age > 65) followed by 0.7-1 mcg/kg per hour infusion iv	PRO Target Controlled Infusion (OAAS scale ≤ 4)	DEX was a new representative for endoscopic sedation. The acceptance level after PRO was relatively high compared with DEX
Takimoto et al[58]	ESD	90	Group D: DEX 3 mcg/kg followed by 0.4 mcg/kg per hour infusion iv	Group P: PRO 5 mg bolus and 3 mg/kg per hour infusion iv, Group M: MDZ 0.1 mg/kg iv	DEX was effective and safe for patients with gastric tumors who underwent ESD

¹Negative result of dexmedetomidine. EGD: Esophagogastroduodenoscopy; ERCP: Endoscopic retrograde cholangiopancreatography; DEX: Dexmedetomidine; MDZ: Midazolam; PRO: Propofol; FEN: Fentanyl; MEP: Meperidine; REM: Remifentanil; ETO: Etomidate; KET: Ketamine; SUF: Sufentanil; PCS: Patient controlled sedation.