Abstract:

Objectives: To evaluate dexmedetomidine as an adjunct drug to propofol during ERCP, and its effects on hemodynamics.Methods: 80 patients ASA (I-II) scheduled for ERCP procedure were randomly classified to either dexmedetomidine/propofol group or propofol group. In Dexmedetomidine /Propofol group, induction was done using dexmedetomidine (0.5 μg/kg), propofol (50 mg), fentanyl 1μg/kg plus atracurium 0.5mg/kg followed by endotracial intubation. Maintainence of anaesthesia was done using infusion of dexmedetomidine(0.4 μg/kg/h) and propofol (0.5-1 mg/kg/h). In Propofol group, induction was done using propofol (50 mg), fentanyl 1 μg/kg followed by atracurium 0.5mg/kg followed by endotracial intubation. Maintaince of anesthesia was done using propofol infusion (0.5-1 mg/kg/h). HR, SBP, DBP, RR, SPO2 and ETCO2 were continuously monitored and recorded at the time points (T0 to T8).Results: Comparing dexmedetomidine/propofol group versus propofol group; PI values showed significant increase at T2 to T7 (p˂0.001), HR values showed significant decrease at T1 to T8 (p 0.013 at T1 and 0.001 at T2 to T8). In dexmedetomidine/propofol group, the propofol dosage was significantly lower (p value 0.001) and the recovery time was significantly higher (p value 0.001) than that of propofol group, while the procedure time was comparable between both groups. Dexmedetomidine/propofol group showed higher incidence of bradycardia than propofol group (p value 0.035) while propofol group showed more cases with tachycardia (p value 0.016) and more cases with airway obstruction (p value 0.026). Conclusion:Dexmedetomidine is a useful adjunct drug during ERCP procedure.

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