Evaluation of dexmedetomidine as a sole agent in sedation of cancer patients undergoing radiological interventional procedures

Background
Previous studies have shown that dexmedetomidine has proven effectiveness as sedative in many outpatient settings and several reports are now available documenting its success for sedation of both non-invasive and invasive procedures.
Objective/purpose
This investigation aimed at evaluation of dexmedetomidine efficacy when used alone for sedation of patients undergoing radiological interventional procedures and measuring its different outcome variables.
Methods
A total of sixty patients who underwent interventional procedures requiring sedation in radiology department were enrolled. Only ages from 18 to 65 years and ASA physical status of I–II were allowed into the study. A loading infusion of one μg/kg over 10 min was started to be followed by a maintenance infusion of 0.2–1 (0.6) μg/kg/h. HR, blood pressure and Spo2 were continuously monitored while pain and sedation were assessed every 10 min by using visual analogue scale (VAS) and Ramsay sedation score (RSS) respectively. cortisol and blood glucose levels were measured pre and post interventionally in addition to the recording of the previously mentioned hemodynamics.
Results
Compared to the pre-sedation values, we observed an acceptable reduction; 11% for blood pressure and 10% for heart rate. Fentanyl was required as a rescue analgesia in 61% of patients enrolled in the study the levels of cortisol and blood glucose in the post intervention period showed statistically significant increase in the post-intervention samples as compared with pre-intervention ones ( < 0.001)
Conclusion
Dexmedetomidine can be used alone for sedation of interventional procedures when minimal to mild pain is in prospect thus provides an alternative for anesthesiologists for high risk patients but cannot be used alone when intense pain is anticipated.