A Comparative study between Dexmedetomidine versus Propofol for sedation in upper GI endoscopy procedure considering effect on intraoperative vital data, patient amnesia and onset of recovery after the procedure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Day Case ◽  
Upper Gi ◽  
Significant Difference ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P < 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P < 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.

scholarly journals Comparison of the Prophylactic Effect of Ondansetron, Dexamethasone, and the Combination of These Drugs on Decreasing Nausea and Vomiting in Children Aged 1 to 12 Years Old Undergoing Upper Gastrointestinal Endoscopy

2019 ◽  
Author(s):  
Amir Shafa ◽  
Anahita Hirmanpour ◽  
Behzad Nazemroaya ◽  
Fateme Jafari ◽  
Arash Pourreza
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Upper Gastrointestinal Endoscopy ◽  
Double Blind ◽  
Upper Gi ◽  
Assessment Time ◽  
Upper Gi Endoscopy ◽  
The Difference ◽  
Upper Gastrointestinal

Background: Endoscopy is a diagnostic and therapeutic method with a high risk of nausea and vomiting. Considering the lack of adequate studies on the prevention of postoperative nausea and vomiting after endoscopy in children, this study was conducted to compare the effects of ondansetron, dexamethasone and a combination of these drugs on the reduction of nausea and vomiting in children aged 1 to 12 years undergoing upper gastrointestinal endoscopy. Methods: In this double-blind, randomized clinical trial, 146 children aged 1 to 12 years, undergoing upper gastrointestinal endoscopy were randomly allocated to four groups of 36. Before endoscopy, the groups received 0.1 mg / kg of ondansetron, 0.2 mg / kg dexamethasone, a combination of the two drugs and placebo, respectively. Results: According to the results of our study, children who underwent upper GI endoscopy, administration of ondansetron plus dexamethasone was associated with a significantly lower frequency of nausea in all assessment time points. However, the difference between the groups was significant only on admission to recovery and the 15 minutes after admission to recovery (P<0.001). Conclusion: The results of our study indicated that in children undergoing endoscopy, the use of ondansetron plus dexamethasone is associated with reduction in the incidence of nausea and vomiting, and the use of the combination does not cause significant side effects compared to ondansetron, dexamethasone or placebo, separately.

scholarly journals Evaluation of 105 Cases of Dyspepsia by Upper Gastrointestinal Endoscopy and Ultrasonography of Hepatobiliary System in a Rural Setting

2019 ◽  
Vol 11 (2) ◽  
pp. 25-29
Author(s):  
Azizun Nessa ◽  
Muhammad Rabiul Hossain ◽  
Md Habibur Rahman ◽  
SM Mizanur Rahman ◽  
Abdullah Al Mamun ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Gastrointestinal Endoscopy ◽  
Cross Sectional Study ◽  
Upper Gastrointestinal Endoscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Upper Gi ◽  
Dyspeptic Symptoms ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Introduction: Dyspepsia affects up to 40% of the general population and significantly reduces the quality of life. Dyspeptic symptoms may be associated with endoscopically negative conditions, such as functional dyspepsia, or with organic lesions like peptic ulcer and oesophagitis which are easily detected by endoscopy. On the other hand, such lesions may also be asymptomatic and there is not always a clear cause and effect relationship between endoscopic findings and symptoms. Objective: To determine the prevalence of significant endoscopic lesion and or ultrasonographic findings and their association with dyspeptic symptoms in Bangladeshi rural population. Materials and Methods: This prospective cross sectional study was carried out in Nov 2015 to Dec 2015 in a field mobile hospital of Bangladesh Army, established in Daudkandi, Comilla where total 1094 uninvestigated dyspeptic patients were invited to participate in this cross sectional study and 105 typical dyspeptic patients were finally recruited as per Rome III criteria. Participants underwent clinical assessment through a preformed structured questionnaire and non video upper gastrointestinal endoscopy (UGIE) and ultrasonogram (USG) of hepatobiliary system (HBS). Results: The mean age of 105 participants (male-29; female-76) studied was 36.51±7.26 years with female preponderance (72.38%). Predominant symptoms were epigastric pain (69.52%), flatulence (34.28%), heart burn (28.57%) and diffuse abdominal pain (22.85%). Regarding treatment 48(45.71%) patients took proton pump inhibitors (PPI), 24 patients (22.85%) took H2 receptor blocker and 13 patients (12.38%) were on antacids irregularly. Seventeen patients (16.15%) had no history of medications for dyspepsia. Most of the patients (76.19%) had symptoms of less than 5 years. Organic dyspepsia was found in 68(64.76%) and functional dyspepsia in 37(35.23%) participants. Percentage of functional dyspepsia in male was 24.13% and in female it was 39.47% and the difference was statistically significant (p<0.05). In the organic dyspepsia group, upper GI endoscopy revealed 07(6.66%) duodenal ulcer, 02(1.9%) gastric ulcer, 04(3.8%) prepyloric ulcer and other inflammatory lesions like prepyloric gastritis in 46(43.80%) patients, antral gastritis in 06(5.7%) patients, duodenitis in 08(7.61%) patients and erosive oesophagitis in 03 patients(2.86%). Further USG revealed cholelithiasis in 02(1.90%) and gall bladder (GB) polyp in 01(0.95%) participants which could be the reason for their dyspeptic symptoms. Thirty Seven (35.23%) participants had normal UGIE (and also normal USG of HBS) but they had significant dyspeptic symptoms. Conclusion: Most of the patients (64.76%) in this study had significant upper GI endoscopic findings and labeled as organic dyspepsia and combined use of upper GI endoscopy and USG of HBS provided better yield for aetiological diagnosis of dyspepsia if there is any. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 25-29

scholarly journals Subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum after upper gastrointestinal endoscopy

2020 ◽  
Vol 13 (11) ◽  
pp. e236369
Author(s):  
Amr Elmoheen ◽  
Mahmoud Haddad ◽  
Khalid Bashir ◽  
Waleed Awad Salem
Keyword(s):  
Subcutaneous Emphysema ◽  
Gastrointestinal Endoscopy ◽  
Quality Of Healthcare ◽  
Upper Gastrointestinal Endoscopy ◽  
Gi Tract ◽  
Negative Effects ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Upper gastrointestinal (GI) endoscopies are performed for several reasons. The overuse of endoscopy has negative effects on the quality of healthcare and pressurises endoscopy services. It also results in the complications. These complications include pneumoperitoneum, pneumomediastinum and subcutaneous pneumomediastinum. However, it is worth noting that these complications rarely occur during endoscopy of the upper GI tract. These complications, when they occur, indicate perforation of the retroperitoneal space or peritoneal cavity. In this article, we discuss a case of pneumoperitoneum, pneumomediastinum and subcutaneous emphysema after upper GI endoscopy.

scholarly journals Upper Gastrointestinal Endoscopy in ENT Practice: How Worth is It?

2013 ◽  
Vol 3 (2) ◽  
pp. 35-38
Author(s):  
MC Anup Kumar ◽  
Lavanya Karanam
Keyword(s):  
Prospective Study ◽  
Gastrointestinal Endoscopy ◽  
Indirect Laryngoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Tertiary Referral ◽  
Gi Endoscopy ◽  
Tertiary Referral Center ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

ABSTRACT Objective The need for upper gastrointestinal (GI) endoscopy in the evaluation of hoarseness. Study design Prospective study, conducted during the period from June 2012 to February 2013. Setting Tertiary referral center. Results A total of 125 patients were selected for the study and they were evaluated with appropriate history and clinical examination. Out of 125 patients, 41 (32.8%) patients showed laryngeal findings leading to hoarseness, 13 (10.4%) patients showed features of suspected malignancy in other adjacent regions which was confirmed later, two (1.6%) patients showed phonetic gap and 69 (55.2%) patients showed normal laryngeal inlet on indirect laryngoscopy examination. Of the 69 normal patients which were treated conservatively and since they did not show any response they were subjected to upper GI endoscopy. Out of 69 patients, 41 (60%) patients showed features of gastritis, 28 (40%) patients showed features of duodenitis. Conclusion It is estimated that more than 50% of patients presenting to the ENT OPD for hoarseness are because of GI problems. We strongly advise upper GI endoscopy for the symptomatic otorhinolaryngological patients with a normal laryngeal finding on indirect laryngoscopy for treating the condition accurately or near accurately. Adding to this upper GI endoscopy has the additional advantages of documentation and medicolegal aspect in the present day scenario. How to cite this article Santosh UP, Kumar MCA, Karanam L. Upper Gastrointestinal Endoscopy in ENT Practice: How Worth is It? Int J Phonosurg Laryngol 2013;3(2):35-38.

scholarly journals Study of upper gastrointestinal endoscopy in patients with gastrointestinal symptoms

2019 ◽  
Vol 6 (10) ◽  
pp. 3595
Author(s):  
Shashidhara Puttaraju ◽  
Sudarshana Sreramaseshadri R. M.
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Gastrointestinal Symptoms ◽  
Significant Risk ◽  
Upper Gastrointestinal Endoscopy ◽  
Therapeutic Tool ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (GI) symptoms are the commonest complaints among the general population and the diseases associated with them carries a significant risk of morbidity and mortality. Hence early diagnosis and appropriate management of the condition can prevent life threatening complications. Upper GI endoscopy is an effective diagnostic as well as therapeutic tool for the patients presenting with upper GI symptoms. The objective of the study is to show the effectiveness of upper gastrointestinal endoscopy as an initial diagnostic, screening and therapeutic tool in patients with upper GI symptoms.Methods: Present study comprises of 100 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out-patients and referred patients) during the period of October 2018 to June 2019, who underwent upper GI endoscopy.Results: Out of 100 patients, 60 were males and 40 were females. In the study majority of the patients were found to have gastritis, esophagitis and acid peptic disease. Other patients had malignant changes, reflux disease, hiatus hernia, perforation, foreign body, obstruction and esophageal varices.Conclusions: Upper GI endoscopy is a simple, safe, more reliable and valuable tool with easy learning curve. It will remain as the initial investigation of choice for the patients with upper GI symptoms. It plays a significant role as a screening, diagnostic as well as therapeutic tool.

Memperbaiki Saturasi Oksigen, Frekuensi Denyut Jantung, dan Pernafasan Neonatus yang Menggunakan Ventilasi Mekanik Dengan Terapi Musik

2013 ◽  
Vol 16 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Rahmadevita S.A.M ◽  
Yeni Rustina ◽  
Elfi Syahreni
Keyword(s):  
Heart Rate ◽  
Mechanical Ventilation ◽  
Music Therapy ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
T Test ◽  
P Value ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
Paired T Test

AbstrakNeonatus yang menggunakan ventilasi mekanik akibat gangguan pernapasan mengalami masalah oksigenisasi dan frekuensi denyut jantung. Berbagai upaya perlu dilakukan agar neonates tenang sehingga kebutuhan oksigen dapat diminimalkan, salah satu upaya tersebut adalah terapi musik. Penelitian ini bertujuan untuk menguji pengaruh terapi musik terhadap saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan neonatus yang menggunakan ventilasi mekanik. Penelitian kuasi eksperimen dengan rancangan pretest-posttest without control meibatkan 13 neonatus yang dipilih secara konsekutif. Intervensi yang diberikan adalah terapi musik dengan Brahm’s Lullaby selama 30 menit dengan headphone. Pengumpulan data menggunakan observasi dan dianalisis dengan Paired t test. Hasil penelitian menunjukkan adanya perbedaan bermakna antara rerata saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan sebelum dan setelah pemberian terapi musik. Pada saturasi oksigen terjadi peningkatan, sedangkan pada frekuensi denyut jantung dan pernapasan mengalami penurunan. Terapi musik dapat digunakan sebagai pendamping terapi medis untuk memperbaiki oksigenisasi pada neonatus yang menggunakan ventilasi mekanik.Kata kunci: denyut jantung neonatus, pernapasan, saturasi oksigen, terapi musik, ventilasi mekanikAbstractImproving Oxygen Saturation, Heart Rate, and Respiratory Rate of Neonates Using Mechanical Ventilation with Music Therapy. Neonates using mechanical ventilation cause of respiratory disorder experience oxygenation and heart rate problems. Interventions should be made in order to calm neonates so that the need of oxygen can be minimized, one of these interventions is music therapy. This study aimed to identify the effect of music therapy on oxygen saturation, heart rate and respiratory rate of neonates using mechanical ventilation. This quasi experiment study with a pretest-posttest design without control involved 13 neonates selected by consecutive sampling. Data collected through observation and analyzed by paired t test. There was a significant difference on the average of oxygen saturation, heart rate and respiratory rate of infants using mechanical ventilation before and after music therapy (p value <0,05). Music therapy can be used as a complementary medical therapies to improve oxygenation in neonates using mechanical ventilation.Key words: heart rate, mechanical ventilation, music therapy, neonate, oxygen saturation, respiratory rate

Safety of balanced propofol and midazolam in upper gastrointestinal endoscopy for sedation in cirrhotic patients

2020 ◽  
pp. 1-13
Author(s):  
Laima Alam ◽  
Mohammad Asif Khattak ◽  
Mafaza Alam
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Recovery Period ◽  
Hepatic Clearance ◽  
Upper Gastrointestinal Endoscopy ◽  
Patient’S Satisfaction ◽  
Dose Time ◽  
Group I ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
Upper Gastrointestinal

Abstract Objective: Sedation for upper gastrointestinal endoscopy (UGIE) in patients with cirrhosis is theoretically associated with high incidence of adverse events due to low levels of binding proteins and decreased hepatic clearance of drugs. The objective of the study was to assess the safety of combined propofol and midazolam sedation in cirrhotic patients undergoing UGIE. Methods: A total of 500 patients undergoing UGIE were divided in to two groups in a prospective observational study from Jan 1st 2018 to June 30th 2018. Group (I) consisted of cirrhotic patients who underwent the procedure with sedation and Group (II) consisted of non-cirrhotic patients who opted for sedation. The main outcome measurements included vitals monitoring before, during and after procedure, total sedation dose, time to initial and deep sedation, recovery time and complications. Results: There was no significant difference between sedation safety and rate of complications for the cirrhotic and non-cirrhotic patients except for the recovery period during initial 10 minutes. The Modified Aldrete score for the cirrhotic patients was 9.5±0.5 min as compared to 9.8±0.4 min for non-cirrhotic patients (p<0.001) at 10 minutes. Grade 2 hepatic encephalopathy was seen in 0.8% of the cirrhotic patients who required hospitalization for 24 hours. Also balanced sedation was acceptable by the patients and the endoscopists equally with statistically significant scores on endoscopist’s assessment of co-operation and assessment of patient’s satisfaction scores. Continuous...

Sign in / Sign up

Export Citation Format

Share Document