IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy

BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidine-based conscious sedation regime and identify risk factors of hemodynamic instability.MethodsA retrospective study was conducted by reviewing the endoscopy record of patients receiving a Dexmedetomidine-based conscious sedation regime for gastrointestinal endoscopy in Tuen Mun Hospital from July 2019 to June 2021. All procedures were performed in the endoscopy room. The titration of sedative agents was determined by in-charge endoscopists. Dexmedetomidine was administered as loading intravenous (IV) infusion (0.5–1mcg/kg) over 10 minutes followed by maintenance IV infusion (0.2–1mcg/kg/hour). Fentanyl was also prescribed as an IV infusion or IV bolus for analgesic effect. Bolus IV Midazolam may be given if necessary to achieve a desirable level of sedation. Blood pressure was recorded at least every 5 minutes while continuous cardiac, oximeter and capnography monitoring were applied to all patients.Results160 endoscopic procedures were performed in 141 patients (80 males & 61 females), with a mean age of 59.6 ± 19 years old (range 16–93), in this analysis (IDDF2022-ABS-0012 Table 1). Hemodynamic instability (defined as systolic blood pressure