Burhanettin USTA, Cansel TÜRKAY, Safinaz KARABAYIRLI

Endoskopi/Kolonoskopide bilinçli sedasyon ve deksmedetomidin

Gastroistestinal sistem muayenesi ve hastalıklarının tedavisinde endoskopi/kolonoskopi altın standarttır, fakat işlemin ağrılı oluşu dezavantajıdır. Sedoanaljezi bu noktada çözüm olabilir. Deksmedetomidin benzodiazepin ve opioidlere alternatif olan yeni bir sedo-analjeziktir. Anestezist gerektirmez. Analjezi, amnezi, sedasyon ve anksiyolitik özellikleri vardır.

Anahtar Kelimeler:

Endoskopi, kolonoskopi, deksmedetomidin, bilinçli sedasyon

Conscious sedation and dexmedetomidine during endoscopy/colonoscopy

Endoscopy and colonoscopy is the gold standard in the examination and the teatment of the disease of gastrointestinal system, but the disadvantage of being painful process. At this point sedoanalgesia may be important. Dexmedetomidine is a new sedo-analgesic which is alternative to benzodiazepines and opioids. It does not require anesthesiologist. And it has analgesia, amnesia, sedative and anxiolytic properties.

Keywords:

Endoscopy, colonoscopy, dexmedetomidine, conscious sedation,

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Chelazzi C, Consales G, Boninsegni P, et al. Propofol sedation in a colo- rectal cancer screening outpatient cohort. Minerva Anestesiol 2009; 75: 677-83.
Candiotti KA, Bergese SD, Bokesch PM, et al. Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, mul- ticenter trial. Anesth Analg 2010; 110: 47-56. Epub 2009 Aug 27.
de Villiers WJ. Anesthesiology and gastroenterology. Anesthesiol Clin 2009; 27: 57-70.
Gasparovic´ S, Rustemovic´ N, Opacic´ M, et al. Clinical analysis of pro- pofol deep sedation for 1,104 patients undergoing gastrointestinal en- doscopic procedures: a three year prospective study. World J Gastroen- terol 2006; 12: 327-30.
Cardin F, Minicuci N, Andreotti A, et al. Maximizing the general success of cecal intubation during propofol sedation in a multi-endoscopist aca- demic centre. BMC Gastroenterol 2010; 10: 123.
Busick T, Kussman M, Scheidt T, Tobias JD. Preliminary experience with dexmedetomidine for monitored anesthesia care during ENT surgical procedures. Am J Ther 2008; 15: 520-7.
Weaver CS, Terrell KM, Bassett R, et al. ED procedural sedation of el- derly patients: is it safe? Am J Emerg Med 2010 Apr 23. [Epub ahead of print]
Qadeer MA, Rocio Lopez A, Dumot JA, Vargo JJ. Risk factors for hypo- xemia during ambulatory gastrointestinal endoscopy in ASA I-II pati- ents. Dig Dis Sci 2009; 54: 1035-40.
Vargo J, Howard K, Petrillo J, et al. Development and validation of the patient and clinician sedation satisfaction index for colonoscopy and up- per endoscopy. Clin Gastroenterol Hepatol 2009; 7: 156-62.
von Delius S, Thies P, Rieder T, et al. Auditory evoked potentials com- pared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy. Am J Gastroenterol 2009;104: 318-25.
Fanti L, Testoni PA. Sedation and analgesia in gastrointestinal endos- copy: What's new? World J Gastroenterol 2010; 16: 2451-7.
Hİj AT, Vilmann P. Propofol for sedation during colonoscopy. A survey of a Cochrane review. Ugeskr Laeger 2010; 172: 1532-4.
Ivano FH, Romeiro PC, Matias JE, et al. Comparative study of efficacy and safety between propofol and midazolam for sedation during colo- noscopy. Rev Col Bras Cir 2010; 37: 10-6.
Vargo JJ, Holub JL, Faigel DO, et al. Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy. Aliment Pharmacol Ther 2006; 24: 955-63.
Akyuz U, Pata C, Senkal V, Erzin Y. Is propofol sedation with midazo- lam induction safe during endoscopic procedures without anesthesiolo- gist? Hepatogastroenterology 2010; 57: 685-7.
Sandiumenge Camps A, Sanchez-Izquierdo Riera JA, Toral Vazquez D, et al. Midazolam and 2% propofol in long-term sedation of traumatized cri- tically ill patients: efficacy and safety comparison. Crit Care Med 2000; 28: 3612-9.
Padmanabhan U, Leslie K, Eer AS, et al. Early cognitive impairment af- ter sedation for colonoscopy: the effect of adding midazolam and/or fen- tanyl to propofol. Anesth Analg 2009; 109: 1448-55.
Nelson LE, Lu J, Guo T, et al. The alpha2-adrenoceptor agonist dexme- detomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology 2003; 98: 428-36.
Szumita PM, Baroletti SA, Anger KE, Wechsler ME. Sedation and anal- gesia in the intensive care unit: evaluating the role of dexmedetomidine. Am J Health Syst Pharm 2007; 64: 37-44.
Guinter JR, Kristeller JL. Prolonged infusions of dexmedetomidine in cri- tically ill patients Am J Health-Syst Pharm 2010; 67: 1246-53.
Hall JE, Uhrich TD, Barney JA, et al. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg 2000; 90: 699-705.
Kamibayashi T, Maze M. Clinical uses of alpha2 -adrenergic agonists. Anesthesiology 2000; 93: 1345-9.
Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative seda- tion. Anesth Analg 2002; 95: 461-6.
Venn RM, Grounds RM. Comparison between dexmedetomine and pro- pofol for sedation in the intensive care unit: patient and clinician percep- tions. Br J Anaesth 2001; 87: 684-90.
Ulger F, Bozkurt A, Bilge SS, et al. The antinociceptive effects of intrave- nous dexmedetomidine in colorectal distension-induced visceral pain in rats: the role of opioid receptors. Anesth Analg 2009; 109: 616-22.
Dere K, Sucullu I, Budak ET, et al. A comparison of dexmedetomidine versus midazolam for sedation, pain and hemodynamic control, during colonoscopy under conscious sedation. Eur J Anaesthesiol 2010; 27: 648-52.
Demiraran Y, Korkut E, Tamer A, et al. The comparison of dexmedeto- midine and midazolam used for sedation of patients during upper en- doscopy: A prospective, randomized study. Can J Gastroenterol 2007; 21: 25-9.
Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy. Anesthesiology 2005; 103: 269-73.
Tobias JD, Berkenbosch JW. Sedation during mechanical ventilation in infants and children: dexmedetomidine versus midazolam. South Med J 2004; 97: 451-5.