Feasibility of non‐anesthesiologist‐administered sedation with dexmedetomidine and midazolam during endoscopic submucosal dissection of upper gastrointestinal tumors
2024

Sedation with Dexmedetomidine and Midazolam by Non-Anesthesiologists

Sample size: 68 publication Evidence: moderate

Author Information

Author(s): Ishido Kenji, Tanabe Satoshi, Kitahara Gen, Furue Yasuaki, Wada Takuya, Watanabe Akinori, Matsuda Hiromi, Okamoto Hirotsugu, Kusano Chika

Primary Institution: Kitasato University School of Medicine

Hypothesis

The efficacy and safety of a sedation regimen combining dexmedetomidine and midazolam during endoscopic submucosal dissection for upper gastrointestinal tumors remains unclear.

Conclusion

A sedation regimen combining dexmedetomidine and midazolam can be feasibly administered by non-anesthesiologists.

Supporting Evidence

  • All endoscopic submucosal dissection procedures were completed successfully.
  • 44.1% of patients experienced hypotension, and 44.1% experienced bradycardia.
  • 1.5% of patients had peripheral arterial oxygen saturation below 90%.

Takeaway

Doctors who aren't anesthesiologists can safely give patients sedation using a mix of two medicines during certain stomach procedures.

Methodology

The study retrospectively evaluated 68 patients who underwent endoscopic submucosal dissection for upper gastrointestinal tumors, sedated by non-anesthesiologists under supervision.

Potential Biases

Selection bias may exist due to the clinical practice perspective.

Limitations

The study was a single-center, retrospective, observational study without randomized controlled trials.

Participant Demographics

Median age was 74 years for superficial esophageal cancer and 75 years for early gastric cancer and gastric adenoma; 13 males and 1 female for superficial esophageal cancer, and 43 males and 11 females for early gastric cancer and gastric adenoma.

Statistical Information

P-Value

0.012

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1002/deo2.70045

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