Concious sedation for endoscopic retrograde cholangio pancreatography using dexmedetomidine and propofol: a comparitive study

Objectives: This comparative study was carried out between Propofol and Dexmedetomidine in patients undergoing Endoscopic Retrograde Cholangio Pancreatography using conscious sedation to evaluate hemodynamic profile and sedation score .
Materials and Methods: 40 patients of either sex in the age group of 20 to 60 years in ASA I and ASA II were randomly selected and assigned into two groups for the study.Group D received an intial infusion of Inj Dexmedetomidine 1mcg/kg/min for 10 min followed by an infusion of 0.2- 0.6mcg/kg/min titrated to Ramsey sedation score of 3-4.Group P received an initial bolus of 1mg/kg Propofol followed by intermittent bolus of 10mg titrated to Ramsey sedation score of 3 to 4.Patients systolic and diastolic pressures, heart rate and pain was also measured.
Results: Patients receiving Dexmedetomidine (Group D) had lower heart rate starting 25 min and at 30,35,40 min (p<0.05). No significant difference was observed in the Mean arterial pressure (MAP) between both groups. 5 patients from Group P and 2 patients from Group D had gag reflex. 08 patients from Group P had coughing and nausea while 02 patients from Group D had the same. When patient and physician satisfaction were compared between both the groups patients receiving Dexmedetomidine showed higher satisfaction levels.
Conclusion: Use of Dexmedetomidine for conscious sedation in patients undergoing ERCP may be a better alternative. However in view of lower heart rate associated with the use of Dexmedetomidine further research into its usefulness may be required.