title: Sedation with dexmedetomidine hydrochloride during endoscopic submucosal dissection of gastric cancer.
abstract: OBJECTIVE
  Although the treatment of early gastric cancer with endoscopic submucosal dissection (ESD) has been widely carried out, a standardized method of sedation for ESD has not been established. The purpose of the present study was to evaluate the efficacy and safety of sedation with dexmedetomidine (DEX).
  
  
  METHODS
  We conducted a randomized study involving 90 patients with gastric tumors who were intended to be treated with ESD. The patients were sedated either with DEX (i.v. infusion of 3.0 µg/kg per h over 5 min followed by continuous infusion at 0.4 µg/kg per h [n = 30]), propofol (PF [n = 30]), or midazolam (MDZ [n = 30]). In all groups, 1 mg MDZ was added i.v. as needed.
  
  
  RESULTS
  En bloc resection of the gastric tumor was achieved in 88 (98%) patients. None of the DEX-sedated patients showed a significant reduction of the oxygen saturation level. The percentage of patients who showed body movement in the DEX group was significantly lower than those in the PF and MDZ groups, and the mean dose of additional MDZ in the DEX group was significantly smaller than that in the MDZ group. The rate of effective sedation was significantly higher in the DEX group compared with the MDZ or PF group. The mean length of ESD in the DEX group was 65 min, which was significantly shorter than in the other two groups. No DEX-sedated patient developed major surgical complications.
  
  
  CONCLUSIONS
  Sedation with DEX is effective and safe for patients with gastric tumors who are undergoing ESD.
authors.affiliation: Gastroenterology, Takeda General Hospital, Kyoto, Japan. k-takimoto-kengo-1209-1209@y8.dion.ne.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Takimoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ueda
authors.forename: Fukutaro
authors.initials: F
authors.lastname: Shimamoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kojima
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fujinaga
authors.forename: Atufumi
authors.initials: A
authors.lastname: Kashiwa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Kiichi
authors.initials: K
authors.lastname: Matsuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Toyonaga
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001143:Arousal / Q000187:drug effects; D016292:Procedural Sedation; D020927:Dexmedetomidine; D004210:Dissection / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D009367:Neoplasm Staging; D015742:Propofol; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam; D015742:Propofol