Dexmedetomidine and propofol for cerebral angiography in non-intubated patients: A comparative study

Abstract

Context: Patients posted for cerebral angiography may be restless and drowsy with high chance of inadvertent movements. Aims: The primary objective was to compare the incidence of inadvertent movements between propofol and dexmedetomidine groups. The secondary objectives include comparison of recovery time and characteristics, Steward’s score, and haemodynamic and respiratory parameters between the two groups. Settings and Design: Prospective, randomised, double-blind, pilot study. Materials and Methods: In all, 20 adult uncooperative, drowsy patients were randomised to dexmedetomidine (1 μg/kg bolus over 10 minutes followed by 0.3-0.7 μg/kg/hour infusion) or propofol (100 μg/kg/min for 10 minutes followed by 25-75 μg/kg/min infusion). Rate of movement, success of sedation, haemodynamics, respiratory parameters, Steward’s recovery score and recovery time were recorded. Statistical analysis used: Repeated measures of analysis of variance, Mann-Whitney test, independent and paired t-tests, and Fisher test. Results: The median rate of movement was similar (1, P = 0.206) with success of sedation achieved in 7 (70%) patients in Group D and 9 (90%) patients in Group P, which was comparable (P = 0.582). The median recovery time in patients in Group D was 150 (37–764) seconds and in Group P was 128 (54–174) seconds (P = 0.519) with similar Steward’s scores (P = 0.363). Haemodynamics and respiratory variables were well-maintained during loading and maintenance dose infusions in both the groups. Conclusions: Dexmedetomidine is a safe alternative for diagnostic cerebral angiography. Its success of sedation, median rate of movement during the imaging procedure, haemodynamics, respiratory parameters, recovery time and Steward’s recovery score were similar to propofol in our study.

Keywords

• cerebral angiography
• dexmedetomidine
• non-intubated
• propofol
• sedation