• Kengo Takimoto, Tomohiro Ueda, Fukutaro Shimamoto, Yusuke Kojima, Yosuke Fujinaga, Atufumi Kashiwa, Hiroaki Yamauchi, Kiichi Matsuyama, Takashi Toyonaga, and Toshikazu Yoshikawa.
• Gastroenterology, Takeda General Hospital, Kyoto, Japan. k-takimoto-kengo-1209-1209@y8.dion.ne.jp
• Dig Endosc. 2011 Apr 1;23(2):176-81.

AimAlthough the treatment of early gastric cancer with endoscopic submucosal dissection (ESD) has been widely carried out, a standardized method of sedation for ESD has not been established. The purpose of the present study was to evaluate the efficacy and safety of sedation with dexmedetomidine (DEX).MethodsWe conducted a randomized study involving 90 patients with gastric tumors who were intended to be treated with ESD. The patients were sedated either with DEX (i.v. infusion of 3.0 µg/kg per h over 5 min followed by continuous infusion at 0.4 µg/kg per h [n = 30]), propofol (PF [n = 30]), or midazolam (MDZ [n = 30]). In all groups, 1 mg MDZ was added i.v. as needed.ResultsEn bloc resection of the gastric tumor was achieved in 88 (98%) patients. None of the DEX-sedated patients showed a significant reduction of the oxygen saturation level. The percentage of patients who showed body movement in the DEX group was significantly lower than those in the PF and MDZ groups, and the mean dose of additional MDZ in the DEX group was significantly smaller than that in the MDZ group. The rate of effective sedation was significantly higher in the DEX group compared with the MDZ or PF group. The mean length of ESD in the DEX group was 65 min, which was significantly shorter than in the other two groups. No DEX-sedated patient developed major surgical complications.ConclusionsSedation with DEX is effective and safe for patients with gastric tumors who are undergoing ESD.© 2010 The Authors. Digestive Endoscopy © 2010 Japan Gastroenterological Endoscopy Society.

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