title: Satisfaction and safety using dexmedetomidine or propofol sedation during endoscopic oesophageal procedures: A randomised controlled trial.
abstract: Dexmedetomidine possesses anxiolytic and hypnotic properties without respiratory side-effects, making it theoretically an ideal sedative agent for endoscopic procedures.
  
  
  
  We aimed to compare satisfaction and safety among outpatients receiving sedation with dexmedetomidine or propofol for endoscopic oesophageal procedures.
  
  
  
  A randomised controlled study.
  
  
  
  Endoscopic intervention suite at the Academic Medical Centre in Amsterdam, Netherlands.
  
  
  
  Patients aged at least 18 years, and American Society of Anesthesiologists' physical status 1 to 3.
  
  
  
  Total 63 patients were randomised to receive either dexmedetomidine (D) or propofol (P). Pain was treated with alfentanil in both groups.
  
  
  
  The primary outcomes were patients' and endoscopists' satisfaction levels measured by validated questionnaires (1 = very dissatisfied; 7 = highly satisfied). A secondary outcome was safety, determined by blood pressure, heart rate and oxygen saturation during and after the procedure, and respiratory rate and noninvasive cardiac output during the procedure.
  
  
  
  Satisfaction of patients [median (IQR); group D, 5.0 (3.75 to 5.75) vs. group P, 6.25 (5.3 to 6.5)] and satisfaction of gastroenterologists [group D, 5.0 (4.4 to 5.8) vs. group P, 6.0 (5.4 to 6.0)] were lower in group D (both P < 0.001). More patients in group D would not recommend this form of sedation to one of their friends (group D, 15 of 32 vs. group P, 1 of 31; P < 0.001). Total 30 min after the procedure, heart rate [group D, 60 bpm (52 to 69) vs. group P, 70 bpm (60 to 81), P = 0.031] and SBP group D, 112 mmHg (92 to 132) vs. group P, 120 mmHg (108 to 132); P = 0.013] were significantly lower after dexmedetomidine sedation. There were no other differences in safety between groups.
  
  
  
  Compared with propofol, sedation with dexmedetomidine resulted in less satisfaction, and caused prolonged haemodynamic depression after endoscopic oesophageal procedures.
  
  
  
  ISRCTN Register (ISRCTN 68599804).
authors.affiliation: From the Department of Anaesthesiology (SE, BP, MWH), Department of Gastroenterology & Hepatology (JJB), and Clinical Research Unit, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands (SVD).
authors.forename: Susanne
authors.initials: S
authors.lastname: Eberl
authors.forename: Benedikt
authors.initials: B
authors.lastname: Preckel
authors.forename: Jacques J
authors.initials: JJ
authors.lastname: Bergman
authors.forename: Susan
authors.initials: S
authors.lastname: van Dieren
authors.forename: Markus W
authors.initials: MW
authors.lastname: Hollmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D004724:Endoscopy / Q000009:adverse effects*; D004947:Esophagus / Q000187:drug effects* / Q000601:surgery; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D015742:Propofol