Comparing the Efficacy and Safety of Dexmedetomidine-Lidocaine and Propofol-Fentanyl-Midazolam Combinations during Endoscopic Retrograde Cholangiopancreatography

Abstract

Background and Aims: Propofol is commonly used for providing sedation in endoscopic retrograde cholangio-pancreatography (ERCP). It?s simple to use and effective but presents cardiovascular and respiratory adverse effects. Recently, dexmedetomidine has been tried but very little evidence exists to support its use. The aim of this study was to compare the efficacy and safety of combination of dexmedetomidine and lidocaine (DL) with the standard propofol-fentanyl (PF) regimen. Methods: After approval of the hospital ethics committee, 63 patients (18-60 years of age) were randomly divided into 2 groups. Thirty-one patients received a PF combination (group PF), and 32 patients received DL combination (group DL). The level of sedation was adjusted to achieve a Ramasy Sedation Scale (RSS) score of 3 (moderate sedation) in both groups of patients. Arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) during ERCP and recovery was continuously assessed. Results: The oxygen saturation (SpO2) showed high statistical significant differences between both groups throughout the procedure with stability in DL group (P0.05). Post-procedural recovery time was significantly shorter in PF group (15.97?3.27 min) compared with (19.38?5.64 min) DL group (p