Comparative Study between Propofol and Dexmedetomidine for Conscious Sedation in Patients Undergoing Outpatient Colonoscopy

Harish Karanth, Sumesh Murali, Reshma Koteshwar, Vasanth Shetty, Karunakara Adappa, Harish Karanth, Sumesh Murali, Reshma Koteshwar, Vasanth Shetty, Karunakara Adappa

Abstract

Introduction: Colonoscopy is a mildly painful procedure requiring conscious sedation. Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods. Dexmedetomidine, a newly introduced, highly selective α2-adrenergic receptor agonist possessing hypnotic, sedative, anxiolytic, sympatholytic, and analgesic properties with impressive safety margin, needs to be explored for use in conscious sedation for colonoscopy procedure among South Indian population.

Materials and methods: A prospective randomized comparative study was conducted on patients aged between 25 and 60 years with the American Society of Anesthesiologist physical status classes I and II posted for colonoscopy under monitored anesthesia care. Study group was randomly divided into two groups and administered propofol and dexmedetomidine. The primary outcome variable was assessments of sedation scores between the two groups. Secondary outcome variables were pain score assessments, hemodynamic comparisons, and adverse events among the two groups. Appropriate statistical tests were applied to compare the findings.

Results: After comparisons between the two groups, we found that patients on dexmedetomidine had similar sedation score as that of patients on propofol. However, there was a significantly higher incidence of systemic hypotension. Requirement of rescue analgesia and adverse events and other hemodynamic fluctuation were similar in both the groups.

Conclusion: We conclude that dexmedetomidine has similar efficacy as propofol for conscious sedation required during colonoscopy. Occurrence of systolic hypotension was, however, significantly more among the group receiving dexmedetomidine.

Keywords: Colonoscopy; dexmedetomidine; propofol.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Hemodynamic comparisons between groups with respect to heart rate. The data are expressed as mean ± standard deviation
Figure 2
Figure 2
Hemodynamic comparisons between groups with respect to systolic blood pressure. The data are expressed as mean ± standard deviation
Figure 3
Figure 3
Hemodynamic comparisons between groups with respect to diastolic blood pressure. The data are expressed as mean ± standard deviation
Figure 4
Figure 4
Hemodynamic comparisons between groups with respect to mean blood pressure. The data are expressed as mean ± standard deviation

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Source: PubMed

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