loading page

Efficacy and safety of sedation with dexmedetomidine in adults undergoing gastrointestinal endoscopic procedures
  • +7
  • Rou Tang,
  • Yaqun Huang,
  • Yujia Zhang,
  • Xiaolei Ma,
  • Haoyang Yu,
  • Kaichao Song,
  • Ling Ren,
  • Bin Zhao,
  • Lulu Wang,
  • Wensheng zheng
Rou Tang
Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Materia Medica

Corresponding Author:[email protected]

Author Profile
Yaqun Huang
Department of Pharmacy, Hospital of Honghe State Affiliated to Kunming Medical University, Southern Central Hospital of Yunnan Province
Author Profile
Yujia Zhang
Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Materia Medica
Author Profile
Xiaolei Ma
Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Materia Medica
Author Profile
Haoyang Yu
Institute of Medicinal Biotechnology, Chinese Academy of Medical Science and Peking Union Medical College
Author Profile
Kaichao Song
Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Materia Medica
Author Profile
Ling Ren
Institute of Medicinal Biotechnology, Chinese Academy of Medical Science and Peking Union Medical College
Author Profile
Bin Zhao
Peking Union Medical College Hospital
Author Profile
Lulu Wang
Institute of Medicinal Biotechnology, Chinese Academy of Medical Science and Peking Union Medical College
Author Profile
Wensheng zheng
Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Materia Medica
Author Profile

Abstract

Background and aim: The sedative role of dexmedetomidine (DEX) in gastrointestinal endoscopic procedures is unclear, highlighting the need to compare DEX with conventional sedatives for a full evaluation. We performed this systematic review and meta-analysis to assess the efficacy and safety of sedation with DEX alone or in combination during gastrointestinal endoscopic procedures with a view to providing guidance for clinical application. Methods: The PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were searched for randomized controlled trials from inception to July 1, 2022. Standardized mean difference and weighted mean difference with 95% confidence interval or pooled risk ratios with 95% CI was used for continuous outcomes or dichotomous outcomes, respectively, and a random-effect model was selected regardless of the significance of the heterogeneity. Results: Forty-one studies with 3,015 patients were assessed, of which 1,363 patients were in the DEX group and 1,652 patients were in the control (without DEX) group. We found that DEX administration decreased the risk of body movements or gagging, hypoxia, and cough, reduced the additional requirement for other sedatives, and increased the endoscopist satisfaction level, however, induction time, and risk of bradycardia, and without statistical differences in RSS score, patient satisfaction level, recovery time, hypotension, nausea, and vomiting. Conclusion: DEX may benefit patients undergoing gastrointestinal endoscopic procedures in some clinical outcomes, whilst some potential disadvantages also exist. Remarkably, DEX was non-inferior to midazolam and propofol in terms of sedation level. In conclusion, DEX is an alternative option for sedation in gastrointestinal endoscopic procedures.