Nishikawa Hiroki, Iwata Yoshinori, Ishii Akio, Enomoto Hirayuki, Yuri Yukihisa, Ishii Noriko, Miyamoto Yuho, Hasegawa Kunihiro, Nakano Chikage, Takata Ryo, Nishimura Takashi, Yoh Kazunori, Aizawa Nobuhiro, Sakai Yoshiyuki, Ikeda Naoto, Takashima Tomoyuki, Iijima Hiroko, Nishiguchi Shuhei
Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
BMJ Open Gastroenterol. 2017 Jun 1;4(1):e000149. doi: 10.1136/bmjgast-2017-000149. eCollection 2017.
Dexmedetomidine (DEX) is a novel, highly selective α2-adrenoceptor agonist that elicits sedative, amnestic, sympatholytic and analgesic effects in patients. Several Japanese investigators have reported the clinical usefulness of DEX for sedation in endoscopic therapies for gastrointestinal malignancies; however, there have been limited data regarding the usefulness and safety of DEX for sedation during endoscopic procedures for oesophageal varices (OVs), such as endoscopic injection sclerotherapy (EIS). In this prospective, single-arm interventional study, we aimed to elucidate these issues.
Patients who require two or more sessions of prophylactic EIS for the treatment of OVs will be enrolled in this prospective interventional study. EIS procedures include two methods: (1) sedation during endoscopic procedures will be performed using conventional methods (pentazocine (PNZ) and midazolam (MDZ)), and (2) sedation during endoscopic procedures will be performed using PNZ, low-dose MDZ and DEX. These two methods were randomly assigned in the first and second EIS. The effect and safety of these two procedures with respect to patient sedation are to be compared with the degree of sedation evaluated using the Bispectral Index monitoring system (Aspect Medical Systems, Norwood, Massachusetts, USA).
This study received approval from the Institutional Review Board at Hyogo College of Medicine (approval no. 2324). The authors are committed to publishing the study results as widely as possible in peer-reviewed journals, and to ensuring that appropriate recognition is provided to everyone who is working on this study.
UMIN000026688; Pre-results.
右美托咪定(DEX)是一种新型的、高度选择性的α2肾上腺素能受体激动剂,可在患者中产生镇静、遗忘、抗交感神经和镇痛作用。几位日本研究人员报告了DEX在胃肠道恶性肿瘤内镜治疗中用于镇静的临床实用性;然而,关于DEX在食管静脉曲张(OVs)内镜手术(如内镜注射硬化疗法(EIS))期间用于镇静的有效性和安全性的数据有限。在这项前瞻性单臂干预研究中,我们旨在阐明这些问题。
需要进行两次或更多次预防性EIS治疗OVs的患者将纳入这项前瞻性干预研究。EIS程序包括两种方法:(1)内镜手术期间的镇静将采用传统方法(喷他佐辛(PNZ)和咪达唑仑(MDZ))进行,(2)内镜手术期间的镇静将采用PNZ、低剂量MDZ和DEX进行。这两种方法在第一次和第二次EIS中随机分配。将使用脑电双频指数监测系统(美国马萨诸塞州诺伍德的Aspect Medical Systems公司)评估镇静程度,比较这两种程序在患者镇静方面的效果和安全性。
本研究获得了兵库医科大学机构审查委员会的批准(批准号2324)。作者致力于在同行评审期刊上尽可能广泛地发表研究结果,并确保对参与本研究的每一个人给予适当认可。
UMIN000026688;预结果。