TY - JOUR
T1 - Dexmedetomidine vs propofol for gastrointestinal endoscopy
T2 - A meta-analysis
AU - Nishizawa, Toshihiro
AU - Suzuki, Hidekazu
AU - Hosoe, Naoki
AU - Ogata, Haruhiko
AU - Kanai, Takanori
AU - Yahagi, Naohisa
N1 - Funding Information:
This work was supported by a Grant-in-Aid for Scientific Research (B) (16H05291, to HS), MEXT-Supported Program for the Strategic Research Foundation at Private Universities (S1411003, to HS) and Keio Gijuku Academic Development Funds (to HS).
Funding Information:
During the last two years, HS received scholarship funds for the research from Otsuka Pharmaceutical Co. Ltd and received service honoraria from Astellas Pharm Inc, Astra-Zeneca K.K., Otsuka Pharmaceutical Co. Ltd, Takeda Pharmaceutical Co. Ltd, Mylan EPD, and Zeria Pharmaceutical Co. Ltd. TK received scholarship funds for the research from Astellas Pharm Inc, Astra-Zeneca K.K., Otsuka Pharmaceutical Co. Ltd, Takeda Pharmaceutical Co. Ltd, Eisai Pharmaceutical Co. Ltd, Zeria Pharmaceutical Co. Ltd, Tanabe Mitsubishi Pharmaceutical Co. Ltd, JIMRO Co. Ltd, Kyorin Pharmaceutical Co. Ltd, and received service honoraria from Astellas Pharm Inc, Eisai Pharmaceutical Co. Ltd, JIMRO Co. Ltd, Tanabe Mitsubishi Pharmaceutical Co. Ltd, Otsuka Pharmaceutical Co. Ltd, Takeda Pharmaceutical Co. Ltd, Miyarisan Pharmaceutical Co. Ltd, and Zeria Pharmaceutical Co. Ltd. N.Y. received scholarship funds for the research from Takeda Pharmaceutical Co. Ltd, Eisai Co, Kaigen Pharm Co. Ltd, Boston Scientific Japan K.K., Nihon Pharmaceutical Co. Ltd, Hoya corporation and Otsuka Pharmaceutical Co. Ltd. OH received scholarship funds for the research from Mochida Seiyaku Co., Ltd. JIMRO Co. Ltd, Takeda Pharmaceutical Co. Limited, Tanabe Mitsubishi Pharmaceutical Co. Ltd, Kyorin Pharmaceutical Co. Limited, Otsuka Pharmaceutical Co. Ltd, Astellas Pharma Inc, Eisai Co. Ltd, Zeria Pharmaceutical Co. Ltd, AstraZeneca K.K., and Boston Scientific Japan K.K. The funding source had no role in the design, practice or analysis of this study.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background and aim: Several randomized controlled trials have compared sedation with dexmedetomidine and propofol in gastrointestinal endoscopy, with contradictory results. We conducted a meta-analysis of data from randomized controlled trials that compared dexmedetomidine with propofol. Methods: We searched PubMed, the Cochrane library, and the Igaku-chuo-zasshi database for randomized trials eligible for inclusion in our meta-analysis. We identified six eligible randomized trials from the database search, and compared the effect of propofol versus dexmedetomidine with respect to: (a) patient’s satisfaction level, (b) body movement or gagging, (c) cardiopulmonary complications, and (d) change in heart rate. Data from eligible studies were combined to calculate pooled risk difference (RD) or weighted mean difference (WMD). Results: Compared to propofol, dexmedetomidine significantly decreased the patient’s satisfaction level (WMD: –0.678, 95% confidence interval (CI): –1.149 to –0.207, p = 0.0048), and there was no significant heterogeneity among the trial results. The pooled RD for developing body movement or gagging when using dexmedetomidine was 0.107 (95% CI: –0.09 to 0.305, p = 0.288), with no significant differences. Compared with propofol, the pooled RD for hypotension, hypoxia, and bradycardia with dexmedetomidine sedation were –0.029 (95% CI: –0.11 to 0.05), –0.080 (95% CI: –0.178 to 0.018), and 0.022 (95% CI: –0.027 to 0.07), respectively, with no significant differences. Compared to propofol, dexmedetomidine significantly decreased the heart rate (WMD: –10.41, 95% CI: –13.77 to –7.051, p ≤ 0.0001), without significant heterogeneity. Conclusions: In gastrointestinal endoscopy, patient satisfaction level was higher in propofol administration, when compared to dexmedetomidine. The risk of complications was similar.
AB - Background and aim: Several randomized controlled trials have compared sedation with dexmedetomidine and propofol in gastrointestinal endoscopy, with contradictory results. We conducted a meta-analysis of data from randomized controlled trials that compared dexmedetomidine with propofol. Methods: We searched PubMed, the Cochrane library, and the Igaku-chuo-zasshi database for randomized trials eligible for inclusion in our meta-analysis. We identified six eligible randomized trials from the database search, and compared the effect of propofol versus dexmedetomidine with respect to: (a) patient’s satisfaction level, (b) body movement or gagging, (c) cardiopulmonary complications, and (d) change in heart rate. Data from eligible studies were combined to calculate pooled risk difference (RD) or weighted mean difference (WMD). Results: Compared to propofol, dexmedetomidine significantly decreased the patient’s satisfaction level (WMD: –0.678, 95% confidence interval (CI): –1.149 to –0.207, p = 0.0048), and there was no significant heterogeneity among the trial results. The pooled RD for developing body movement or gagging when using dexmedetomidine was 0.107 (95% CI: –0.09 to 0.305, p = 0.288), with no significant differences. Compared with propofol, the pooled RD for hypotension, hypoxia, and bradycardia with dexmedetomidine sedation were –0.029 (95% CI: –0.11 to 0.05), –0.080 (95% CI: –0.178 to 0.018), and 0.022 (95% CI: –0.027 to 0.07), respectively, with no significant differences. Compared to propofol, dexmedetomidine significantly decreased the heart rate (WMD: –10.41, 95% CI: –13.77 to –7.051, p ≤ 0.0001), without significant heterogeneity. Conclusions: In gastrointestinal endoscopy, patient satisfaction level was higher in propofol administration, when compared to dexmedetomidine. The risk of complications was similar.
KW - Dexmedetomidine
KW - endoscopy
KW - meta-analysis
KW - propofol
KW - randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85032992097&partnerID=8YFLogxK
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U2 - 10.1177/2050640616688140
DO - 10.1177/2050640616688140
M3 - Article
AN - SCOPUS:85032992097
VL - 5
SP - 1037
EP - 1045
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
SN - 2050-6406
IS - 7
ER -