A randomized study of intranasal vs. intravenous infusion of dexmedetomidine in gastroscopy

To compare the respiratory and circulatory parameters between intranasal and intravenous dexmedetomidine in gastroscopy.

60 patients undergoing elective gastroscopy were randomly divided into group D1 and D2. Dexmedetomidine (0.5 µg/kg, 1 mL) and normal saline (NS, 1 mL) were given by intranasal route 40 minutes before induction, and then NS (20 mL) and dexmedetomidine (0.5 µg/kg, 20 mL) were given intravenously 10 minutes before induction, respectively, in groups D1 and D2. Propofol (1.5 - 2 mg/kg) was used for induction. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation(SpO₂), and respiratory rate (RR) were monitored. The latent period of falling asleep, the duration of gastroscopy, the time of awakening, and the total dose of propofol consumption were also recorded. Postoperative sedation scale and adverse reactions were observed.

One patient in group D1 was excluded from the study due to atrioventricular block. The HR and SpO₂ were significantly lower, but RR was significantly higher in group D2 than in group D1(all p < 0.05). The time of awakening was significantly longer and the rates of respiratory depression were significantly higher in group D2 than in group D1 (all p < 0.05) There were no significant differences in other parameters between both groups.

Intranasal dexmedetomidine is a new, safe, and effective approach for gastroscopy because it has more stable respiratory and circulatory parameters and less adverse reactions than intravenous dexmedetomidine.