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• W2331826277 abstract "Midazolam and dexmedetomidine, which are used for sedation during endoscopic retrograde cholangiopancreatography, were compared to evaluate the differences in efficacy, hemodynamics, and side effects.Fifty patients aged between 18 and 80 were randomly assigned to two groups according to American Society of Anesthesiologists (ASA) classification: Group M received midazolam with an initial bolus infusion of 0.04 mg/kg intravenously (i.v.), followed by additional doses of 0.5 mg i.v. midazolam, titrated to achieve a Ramsay sedation scale score of 3-4. Group D received dexmedetomidine with an initial bolus infusion of 1 mcg/kg/hr i.v. over 10 minutes, followed by a continuous infusion of 0.2-0.7 mcg/kg/hr, titrated to achieve an RSS of 3-4. A Mini Mental Status Examination (MMSE) was performed prior to sedation and in the recovery room once the Modified Aldrete Score (MAS) reached 9-10. Patient heart rates, arterial pressure and pain were evaluated.Patients in Group D had lower heart rates at 20, 25, 30, 35 and 40 minutes following the initiation of sedation (p<0.05). There was no statistical difference in arterial pressure, RSS, MMSE or respiratory rate between the two groups. Coughing, nausea and vomiting occurred in 3 patients in Group M (12%), whereas no patient in Group D experienced these symptoms. The procedure elicited a gag response in 7 patients in Group M (28%) and in 4 patients in Group D (16%), with no significant difference between groups (p>0.05). When patient and surgeon satisfaction was compared between the two groups, Group D showed higher surgeon satisfaction scores (p<0.05).The use of dexmedetomidine for conscious sedation during short, invasive procedures, such as endoscopic retrograde cholangiopancreatography, could be a superior alternative to the use of midazolam.Bu çalışmada endoskopik retrograd kolonjiopankreatografi işlemi sırasında bilinçli sedasyon için uygulanan midazolam ve deksmedetomidinin hemodinami ve solunum parametreleri ve yan etkiler açısından karşılaştırılmaları amaçlandı.18–80 yaşları arasında, Amerikan Anestezistler Birliği’nin (ASA) sınıflamasına göre I ve II anestezi risk grubuna giren 50 olgu çalışmaya alınarak, çalışma protokolü anlatıldı. Hastalar randomize olarak iki gruba ayrıldı: Grup M’deki olgulara midazolam 0.04 mg kg-1 intravenöz (i.v) uygulandıktan sonra RSS’u 3–4 olacak şekilde 0.5 mg ek dozlarla işleme devam edildi. Grup D’deki olgulara deksmedetomidin 1 μg kg-1 sa-1 olacak şekilde 10 dakika yükleme dozu uygulandı. Takiben olguların RSS’u 3–4 olacak şekilde 0.2–0.7 μg kg-1sa-1 deksmedetomidin infüzyonuna başlandı. Olguların demografik verileri ve çalışma süresince vital bulguları kaydedildi. Sedasyon skorları ölçümünde Ramsay sedasyon skoru kullanıldı. Mini mental test (MMT) olgulara sedasyon öncesinde ve derlenme odasında modifiye Aldrete skoru (MAS) 9–10 olduğunda uygulandı. Ağrı değerlendirilmesinde yüz ağrı ölçeği (YAÖ) kullanıldı.Grup D’de 20, 25, 30, 35, 40. dakikalarda ölçülen kalp hızı değerleri Grup P’ye göre daha düşük bulundu (p<0.05). Grupların kendi arasında ve grup içi karşılaştırılmasında, ortalama arter basıncı değerlerinde istatistiksel olarak anlamlı bir fark bulunmadı. Kognitif fonksiyonlar açısından iki grup karşılaştırıldığında istatistiksel olarak anlamlı farklılık saptanmadı. Komplikasyonlar açısından gruplar karşılaştırıldığında öksürük, bulantı ve kusma Grup M’de 3’er (%12) olguda görülürken, Grup D’de hiçbir olguda gözlenmedi. Öğürme Grup M’de 7 (%28), Grup D’de ise 4 (%16) olguda gözlendi, ancak istatistiksel farklılık saptanmadı (p>0.05). Gruplar arasında cerrah ve hasta memnuniyeti karşılaştırıldığında, Grup D’de cerrah memnuniyetinin daha yüksek olduğu saptandı (p<0.05).Endoskopik retrograd kolonjiopankreatografi ve benzeri kısa süreli invazif işlemlerde deksmedetomidin ile bilinçli sedasyon uygulaması rutinde kullanılan midazolam uygulamalarına önemli bir alternatif olabilir." @default.
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• W2331826277 date "2011-04-01" @default.
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• W2331826277 title "Conscious Sedation for Endoscopic Retrograde Cholangiopancreatography: Dexmedetomidine Versus Midazolam" @default.
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• W2331826277 doi "https://doi.org/10.5152/eajm.2011.03" @default.
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