title: Feasibility of deep sedation with a combination of propofol and dexmedetomidine hydrochloride for esophageal endoscopic submucosal dissection.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the efficacy and safety of sedation with a combination of propofol (PF) and dexmedetomidine (DEX) compared with sedation with benzodiazepines in esophageal endoscopic submucosal dissection (ESD).
  
  
  METHODS
  We retrospectively reviewed clinical data for 40 consecutive patients who had undergone esophageal ESD at the Yokohama City University Hospital between July 2012 and August 2014. Of these patients, 20 were sedated with benzodiazepines (conventional group) and another 20 patients were sedated with a combination of PF and DEX (combination group). Parameters for efficacy and safety of sedation were evaluated by comparisons between the two groups.
  
  
  RESULTS
  Median procedural times in the combination group were shorter than those in the conventional group (61 min vs. 89 min, P = 0.03), and the percentage of patients who showed restlessness in the combination group was significantly lower than that in the conventional group (25% vs. 65%, P = 0.025). Incidences of hypotension and bradycardia in the combination group were higher than those in the conventional group (60% vs. 15%, P = 0.008, and 60% vs. 15%, P = 0.008, respectively).
  
  
  CONCLUSIONS
  This retrospective study suggests that a combination of PF and DEX may provide stable deep sedation with less body movement than benzodiazepines during esophageal ESD.
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Office of Postgraduate Medical Education, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.affiliation: Department of Anesthesiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Miyashita
authors.affiliation: Department of Anesthesiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Harada
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Inoh
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanoshima
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Mizue
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Higurashi
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ohkubo
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.affiliation: Office of Postgraduate Medical Education, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kusakabe
authors.affiliation: Office of Postgraduate Medical Education, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Department of Anesthesiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Gotoh
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D054810:Deep Sedation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D018686:Anesthetics, Intravenous; D020927:Dexmedetomidine; D015742:Propofol
keywords: benzodiazepine; dexmedetomidine; endoscopic submucosal dissection; esophagus; propofol