Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures

The combination Dexmedetomidine-Fentanyl (D) will attempt to reduce hemodynamic changes and intensity of adverse reactions (AR) compared to Propofol-Fentanyl (P) for gastrointestinal endoscopic procedures: Digestive video endoscopies (VEDA), Colonoscopies and endoscopic retrograde cholangiopan...

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Autores principales: Santiago, RG, Gutierrez, CR, Enrique, D
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019
Materias:
dexmedetomidine
PROPOFOL
VEDA
colonoscopy
CPRE
Colonoscopies and endoscopic retrograde cholangiopancreatography
Dexmedetomidina
Propofol
Colonoscopia
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/25685
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-25685
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic dexmedetomidine
PROPOFOL
VEDA
colonoscopy
CPRE
Colonoscopies and endoscopic retrograde cholangiopancreatography
Dexmedetomidina
Propofol
VEDA
Colonoscopia
spellingShingle dexmedetomidine
PROPOFOL
VEDA
colonoscopy
CPRE
Colonoscopies and endoscopic retrograde cholangiopancreatography
Dexmedetomidina
Propofol
VEDA
Colonoscopia
Santiago, RG
Gutierrez, CR
Enrique, D
Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
topic_facet dexmedetomidine
PROPOFOL
VEDA
colonoscopy
CPRE
Colonoscopies and endoscopic retrograde cholangiopancreatography
Dexmedetomidina
Propofol
VEDA
Colonoscopia
author Santiago, RG
Gutierrez, CR
Enrique, D
author_facet Santiago, RG
Gutierrez, CR
Enrique, D
author_sort Santiago, RG
title Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
title_short Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
title_full Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
title_fullStr Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
title_full_unstemmed Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures
title_sort comparison of the safety and effectiveness of the use of dexmedetomidine-fentanyl vs propofol-fentanyl for gastrointestinal endoscopic procedures
description The combination Dexmedetomidine-Fentanyl (D) will attempt to reduce hemodynamic changes and intensity of adverse reactions (AR) compared to Propofol-Fentanyl (P) for gastrointestinal endoscopic procedures: Digestive video endoscopies (VEDA), Colonoscopies and endoscopic retrograde cholangiopancreatography  (ERCP).The objective was to assess the safety and efficacy of Dexmedetomidine and hemodynamic changes, assess analgesic quality and sedation, record oxygen desaturation events, assess the degree of patient satisfaction after the anesthetic act and recovery and identify AR. Bioethical approval CIEIS Hospital Córdoba. Randomized, prospective, double-blind, randomized clinical trial, 60 patients in two groups, Group P: Propofol-Fentanyl, 1mcg / kg Fentanyl and Propofol 1mg / kg and boluses 0.5mg to 1mg / kg. Group D: Dexmedetomidine-Fentanyl, 1mcg / kg Fentanyl and loading Dexmedetomidine 1mcg / kg in 10 minutes and infusion 0.3 to 0.7 mcg / kg / hour. Inclusion criteria: 18-65 years, both sexes, ASA I-III, gastrointestinal endoscopies. Hemodynamic parameters were evaluated: Diastolic blood pressure (ADT), Systolic blood pressure (ASD), Mean Arterial Blood Pressure (ASD), Heart Rate (HR) and Oxygen Saturation (SpO2%); sedation, analgesia, AR, satisfaction and recovery. Fisher's LSD Test, Comparison test of proportions of each category, Wilcoxon test, Kruskal Wallis tests, Chi square independence test were applied. All cases p <0.05. D presented higher values of TAS, TAD, TAM and SO2%, while P presented significantly higher HR values. The level of sedation was significantly higher at the end of the procedure for P. The analgesic quality D recorded greater events of intolerance to the introduction of the endoscope in ERCP. The most frequent AR were significantly to D Bradycardia and arterial hypertension, to P isolated respiratory depression and occasionally associated with arterial hypotension and bradycardia. In anesthetic recovery, P presented arterial hypotension and dizziness more frequently. The level of satisfaction and recovery with Aldrete 10/10 did not show significant differences. The results show that Dexmedetomidine-Fentanyl produces a lower incidence of respiratory depression, less adverse reactions and greater hemodynamic stability. The effective dose for ERCP should still be determined.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2019
url https://revistas.unc.edu.ar/index.php/med/article/view/25685
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spelling I10-R327-article-256852024-08-27T18:26:05Z Comparison of the safety and effectiveness of the use of Dexmedetomidine-Fentanyl Vs Propofol-Fentanyl for gastrointestinal endoscopic procedures Comparación de la seguridad y efectividad del uso de Dexmedetomidina-Fentanilo Vs Propofol-Fentanilo para procedimientos endoscópicos gastrointestinales Santiago, RG Gutierrez, CR Enrique, D dexmedetomidine PROPOFOL VEDA colonoscopy CPRE Colonoscopies and endoscopic retrograde cholangiopancreatography Dexmedetomidina Propofol VEDA Colonoscopia The combination Dexmedetomidine-Fentanyl (D) will attempt to reduce hemodynamic changes and intensity of adverse reactions (AR) compared to Propofol-Fentanyl (P) for gastrointestinal endoscopic procedures: Digestive video endoscopies (VEDA), Colonoscopies and endoscopic retrograde cholangiopancreatography  (ERCP).The objective was to assess the safety and efficacy of Dexmedetomidine and hemodynamic changes, assess analgesic quality and sedation, record oxygen desaturation events, assess the degree of patient satisfaction after the anesthetic act and recovery and identify AR. Bioethical approval CIEIS Hospital Córdoba. Randomized, prospective, double-blind, randomized clinical trial, 60 patients in two groups, Group P: Propofol-Fentanyl, 1mcg / kg Fentanyl and Propofol 1mg / kg and boluses 0.5mg to 1mg / kg. Group D: Dexmedetomidine-Fentanyl, 1mcg / kg Fentanyl and loading Dexmedetomidine 1mcg / kg in 10 minutes and infusion 0.3 to 0.7 mcg / kg / hour. Inclusion criteria: 18-65 years, both sexes, ASA I-III, gastrointestinal endoscopies. Hemodynamic parameters were evaluated: Diastolic blood pressure (ADT), Systolic blood pressure (ASD), Mean Arterial Blood Pressure (ASD), Heart Rate (HR) and Oxygen Saturation (SpO2%); sedation, analgesia, AR, satisfaction and recovery. Fisher's LSD Test, Comparison test of proportions of each category, Wilcoxon test, Kruskal Wallis tests, Chi square independence test were applied. All cases p <0.05. D presented higher values of TAS, TAD, TAM and SO2%, while P presented significantly higher HR values. The level of sedation was significantly higher at the end of the procedure for P. The analgesic quality D recorded greater events of intolerance to the introduction of the endoscope in ERCP. The most frequent AR were significantly to D Bradycardia and arterial hypertension, to P isolated respiratory depression and occasionally associated with arterial hypotension and bradycardia. In anesthetic recovery, P presented arterial hypotension and dizziness more frequently. The level of satisfaction and recovery with Aldrete 10/10 did not show significant differences. The results show that Dexmedetomidine-Fentanyl produces a lower incidence of respiratory depression, less adverse reactions and greater hemodynamic stability. The effective dose for ERCP should still be determined. Con la combinación Dexmedetomidina-Fentanilo (D) se intentará disminuir los cambios hemodinámicos e intensidad de las reacciones adversas (RA) en comparación con Propofol-Fentanilo (P) para procedimientos endoscópicos gastrointestinales: Videoendoscopias digestivas (VEDA), Colonoscopias y Colangiopancreatografía retrógradas endoscópicas (CPRE). El objetivo del trabajo fue evaluar seguridad y eficacia de Dexmedetomidina y cambios hemodinámicos, valorar calidad analgésica y sedación, registrar eventos de desaturación de oxígeno, valorar el grado de satisfacción del paciente luego del acto anestésico y  recuperación e identificar las RA. Aprobación bioética CIEIS Hospital Córdoba. Estudio clínico aleatorio randomizado, prospectivo, doble ciego, 60 pacientes en dos grupos, Grupo P: Propofol-Fentanilo, 1mcg/kg Fentanilo y Propofol 1mg/kg y bolos 0,5mg a 1mg/kg. Grupo D: Dexmedetomidina-Fentanilo, 1mcg/kg Fentanilo y carga Dexmedetomidina 1mcg/kg en 10 minutos e infusión 0,3 a 0,7 mcg/kg/hora. Criterios inclusión: 18-65 años, ambos sexos, ASA I-III, endoscopias gastrointestinales. Se evaluaron parámetros hemodinámicos: Tensión arterial diastólica (TAD), Tensión arterial sistólica (TAS), Tensión Arterial Media (TAM), Frecuencia cardiaca (FC) y Saturación de Oxigeno (SpO2%); sedación, analgesia, RA, satisfacción y recuperación. Se aplicó Test LSD de Fisher, Test de comparación de proporciones de cada categoría, prueba de Wilcoxon, Tests de Kruskal Wallis, Test de independencia de chi cuadrado. En todos los casos p<0,05. D presentó mayores valores de TAS, TAD, TAM y SO2%, mientras que P presentó mayores valores de FC significativamente. El nivel de sedación fue significativamente mayor al finalizar el procedimiento  para P. En calidad analgésica D registró mayores eventos de intolerancia a la introducción del endoscopio en CPRE. Las RA más frecuentes significativamente fueron para D  Bradicardia e Hipertensión arterial,  para P depresión respiratoria aislada y ocasionalmente asociada a hipotensión arterial y bradicardia. En  recuperación anestésica P presentó Hipotensión arterial y mareos con mayor frecuencia. El nivel de satisfacción y la recuperación con Aldrete 10/10 no presentaron diferencias significativas. Los resultados demuestran que Dexmedetomidina-Fentanilo produce menor  incidencia de depresión respiratoria, menos reacciones adversas y mayor estabilidad hemodinámica . Todavía se debe determinar la dosis efectiva para CPRE. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-10-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/25685 Revista de la Facultad de Ciencias Médicas de Córdoba.; 2019: Suplemento JIC XX Revista de la Facultad de Ciencias Médicas de Córdoba; 2019: Suplemento JIC XX Revista da Faculdade de Ciências Médicas de Córdoba; 2019: Suplemento JIC XX 1853-0605 0014-6722 10.31053/1853.0605.v76.nSuplemento spa https://revistas.unc.edu.ar/index.php/med/article/view/25685/27396 Derechos de autor 2019 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

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