Dexmedetomidine versus Fentanyl as Adjuvant to Propofol Total Intravenous Anesthesia during Endoscopic Retrograde Cholangial-Pancreatography Procedure

Abstract

Objective: the aim of this study was to compare the effects of Dexmedetomidine/Propofol and Fentanyl/Propofol combination for conscious sedation in patients undergoing ERCP regarding hemodynamic changes, patients and endoscopists satisfaction. Patients and method: Ninety four (94) ages 18-70 ASA ı-ıı were enrolled in this study. Patients were allocated randomly into two equal groups D/P and F/P groups. Patients received either Fentanyl 1µg/kg or Dexmedetomidine 1µg/kg for 10 min, followed by maintenance dose 0.2µg to 0.5µg/kg/min. combined with propofol 1mg/kg IV and maintenance 3mg/kg/h regimen. With requiring additional dose if sedation level did not reached. Conduct open airway technique was used while applying o₂ through nasal cannula 3L/ min. (MAP, HR and SPO₂) were recorded before and after sedation procedures then every 10min. till the end of procedure, recovery time, postoperative complications, patients and endoscopists were recorded. Results: the intra procedure HR, and BP showed statistical significant differences between both groups throughout the procedure with lower value in group D/P (p=0.042) while there were no statistical significance differences regarding MAP and SPO₂. During postoperative procedure BP and MAP was statistical significant lower in D/P group (p= 0.015). Post procedure recovery time was shorter in group D/P (p= 0.049), regarding PONV was higher in D/P compared to F/P (p=0.03), both group were statistical significant satisfied. Conclusion: Dexmedetomidine/Propofol combination as conscious sedation during ERCP procedure provide intra and post procedure hemodynamic stability, less post procedure complications patients, and endoscopists satisfication compared to Fentanyl/Propofol combination.