In:
British Journal of Clinical Pharmacology, Wiley, Vol. 89, No. 6 ( 2023-06), p. 1799-1808
Abstract:
Dexmedetomidine could be an ideal adjuvant to propofol during gastrointestinal endoscopy because it provides both analgesia and sedation without respiratory depression. This study investigates the effect of different doses of dexmedetomidine on the median effective concentration of propofol during gastrointestinal endoscopy. Methods Ninety adult patients were randomly assigned to Group Control, Group DEX0.5 (0.5 μg/kg dexmedetomidine) or Group DEX1.0 (1.0 μg/kg dexmedetomidine). Anaesthesia during endoscopy was implemented by plasma target‐controlled infusion (TCI) of propofol with different doses of dexmedetomidine. TCI concentration of the first patient for each group was 2.5 μg/mL and the consecutive adjacent concentration gradient was 0.5 μg/mL. Median effective concentration (EC 50 ) of propofol by TCI for gastrointestinal endoscopy was determined by using the modified Dixon's up‐and‐down method. Cardiovascular variables were also measured. Results EC 50 of propofol by TCI and 95% confidence interval (CI) for gastrointestinal endoscopy were 3.77 (3.48–4.09), 2.51 (2.27–2.78) and 2.10 (1.90–2.33) μg/mL in Group Control, Group DEX0.5 and Group DEX1.0, respectively. The average percent change from heart rate (HR) baseline was 2.8 (8.9), −7.4 (7.7) and −10.5 (8.8) ( P 〈 .001), and the average percent change from mean arterial pressure (MAP) baseline was −10.6 [−24.7; 3.5], −9.5 [−29.2; 11.4] and −4.0 [−27.3; 15.5] ( P = .034) in Group Control, Group DEX0.5 and Group DEX1.0, respectively. Conclusions Dexmedetomidine reduced the EC 50 of propofol by TCI. A 0.5–1 μg/kg dose of dexmedetomidine caused a decrease in HR without bradycardia. The decrease in dosage of propofol with increasing doses of dexmedetomidine caused more stable MAP. Dexmedetomidine is an ideal adjuvant drug to propofol during gastrointestinal endoscopy.
Type of Medium:
Online Resource
ISSN:
0306-5251
,
1365-2125
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
1498142-7
SSG:
15,3
