Evaluation of Intranasal Dexmedetomidine in Providing Moderate Sedation in Patients Undergoing ERCP: A Randomized Controlled Trial

Background and Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed under deep sedation. Respiratory depression and airway obstruction are the most dangerous complications of sedatives. Dexmedetomidine is a drug that does not cause respiratory depression so, this study evaluated the efficacy of nasal dexmedetomidine in inducing moderate sedation in patients undergoing ERCP.
In a double blind randomized controlled trial, the patients candidate for ERCP in Firoozgar hospital, were divided into two groups. Group I received normal saline while in group II dexmedetomidine 1µg/kg was administered intranasaly. Also, intravenous midazolam and fentanyl, and if needed, propofol were used for induction of sedation. Then total use of sedative drugs, hemodynamic parameters, patient and physician satisfaction and side effects of treatment were documented.
There were no significant differences in age, sex and BMI between the two groups. Mean use of midazolam and fentanyl was almost similar in two groups but the use of propofol was lower in group II (P= 0.002). The mean heart rate was found to be lower in the group receiving dexmedetomidine but systolic and diastolic blood pressure were almost similar in two groups (P> 0.05). Compared with the results in group I, the patients and physicians in group II were more satisfied with dexmedetomidine.
Dexmedetomidine as an adjuvant drug for sedation in patients undergoing ERCP could reduce the need for other sedatives, and also satisfy both the patients and therapists.