Dexmedetomidine vs propofol for gastrointestinal endoscopy: A meta-analysis
Toshihiro Nishizawa1,2, Hidekazu Suzuki3, Naoki Hosoe4
1Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.
United European Gastroenterology Journal
|November 23, 2017
Summary
Propofol offers higher patient satisfaction than dexmedetomidine for gastrointestinal endoscopy sedation. However, both agents show similar risks for cardiopulmonary complications and body movement during procedures.
Area of Science:
- Gastroenterology
- Anesthesiology
- Clinical Pharmacology
Background:
- Sedation with dexmedetomidine and propofol in gastrointestinal endoscopy has yielded conflicting results across studies.
- A meta-analysis was conducted to reconcile these discrepancies.
Purpose of the Study:
- To compare the efficacy and safety of dexmedetomidine versus propofol for sedation in gastrointestinal endoscopy.
- To analyze patient satisfaction, body movement, gagging, and cardiopulmonary complications.
Main Methods:
- A systematic search of PubMed, Cochrane library, and Igaku-chuo-zasshi identified six eligible randomized controlled trials.
- Data were pooled to calculate weighted mean difference (WMD) for patient satisfaction and heart rate, and risk difference (RD) for complications.
Main Results:
- Dexmedetomidine significantly decreased patient satisfaction compared to propofol (WMD: -0.678, p=0.0048).
- No significant differences were observed in body movement/gagging (RD: 0.107, p=0.288) or cardiopulmonary complications (hypotension, hypoxia, bradycardia).
- Dexmedetomidine significantly decreased heart rate (WMD: -10.41, p≤0.0001) without significant heterogeneity.
Conclusions:
- Propofol is associated with higher patient satisfaction than dexmedetomidine in gastrointestinal endoscopy.
- The risk of adverse events, including cardiopulmonary complications, is comparable between the two sedatives.
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