Sedative Effect of Dexmedetomidine and Midazolam in Transesophageal Echocardiographic Examination

Background and Transesophageal echocardiography (TEE) is established as a sensitive and accurate diagnostic method for the rapid assessment of cardiovascular diseases. It is believed that dexmedetomidine might be useful for sedating patients undergoing TEE. This study compared the use of dexmedetomidine and midazolam in patients undergoing TEE. In a clinical trial, 48 patients undergoing TEE were randomly divided to receive either dexmedetomidine 1µg kg/i.v. over 10 min, followed by 0.2µg kg/i.v infusion, or midazolam 2 mg/i.v. Patients’ sedation level was determined according to Ramsay Sedation Scale, degree of analgesia, patient's satisfaction, arterial pressure, heart rate (HR) and readiness for discharge from recovery room. Degree of analgesia, in the group receiving dexmedetomidine was found higher compared with that of the midazolam group (3.67±0.86 vs 0.83±0.56, P<0.001). The level of patients satisfaction with sedation was also higher in dexmedetomidine group (P=0.001). Readiness for discharge in the two groups were 7.08±1.17 and 3.71±1.57 min, respectively (P=0.001). Blood pressure and heart rate were similar in both groups. Our study suggests that compared to midazolam, dexmedetomidine is more suitable in sedation of patients undergoing TEE.