For patients with obesity undergoing colonoscopy, dexmedetomidine plus oxycodone is a safe and efficacious combination for conscious sedation, according to study results published in Heliyon.
Given that propofol is associated with respiratory depression, researchers sought to examine the safety and efficacy of dexmedetomidine plus oxycodone for conscious sedation during colonoscopy among patients with obesity.
For the analysis, the researchers conducted a randomized, controlled trial that included 120 individuals undergoing a colonic endoscopy (i.e., colonoscopy). Eligible participants were aged 30 to 60 years with a body mass index (BMI) of 30 to 35 and electively undergoing colonoscopy.
The researchers randomly assigned participants to receive dexmedetomidine plus oxycodone (n=61) for sedation or propofol plus oxycodone (n=59).
When comparing the 2 groups, the researchers examined blood pressure, blood oxygen saturation, heart rate, injection pain, and recovery time as outcome measures.
Compared with propofol plus oxycodone, dexmedetomidine plus oxycodone is an efficacious sedative with few side effects during colonoscopy among people with obesity. Dexmedetomidine plus oxycodone also allows some patients to reposition, making the procedure less difficult.
In comparing the treatment groups, hypoxemia was lower with dexmedetomidine plus oxycodone (4.9%) than propofol plus oxycodone (20.3%, P =.011). Blood pressure decreased and heart rate increased in the propofol plus oxycodone group, compared with the dexmedetomidine plus oxycodone group (P <.05).
In addition, the dexmedetomidine plus oxycodone participants experienced a significantly shorter caecal insertion time, recovery time to orientation, and recovery time to walking than the propofol plus oxycodone group (P <.05). Finally, endoscopist satisfaction scores were significantly higher in the dexmedetomidine plus oxycodone group (P =.042).
One limitation was that the researchers could not use the double-blind design throughout the study because some patients reportedly woke up during the procedure or remembered having it. Also, the level of sedation in the 2 groups was not always equivalent.
“[D]exmedetomidine and oxycodone exhibit good sedative effects and minimal respiratory depression during conscious sedation for colonoscopy,” study authors wrote. “Patients generally approve of this sedation technique, which does not significantly increase discomfort related to the procedure. For obese patients, sedation with dexmedetomidine plus oxycodone is worthy to be considered.”
This article originally appeared on Gastroenterology Advisor
Wang X, Zhang M, Sun H. et al. Dexmedetomidine–Oxycodone combination for conscious sedation during colonoscopy in obese patients: a randomized controlled trial. Heliyon. Published online May 16, 2023. doi:10.1016/j.heliyon.2023.e16370