Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection
Abstract Objectives Endoscopic submucosal dissection (ESD) is effective for the resection of colorectal intramucosal lesions. This study was performed to examine the safety and effectiveness of using dexmedetomidine (DEX) in the anesthesia regimen of patients with colorectal lesions undergoing ESD....
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Wiley
2023-04-01
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| Online Access: | https://doi.org/10.1002/deo2.223 |
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| author | Hiroyoshi Iwagami Takuji Akamatsu Kazuki Matsuyama Yusuke Hanawa Kohei Tonomura Eiki Chikugo Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Hisakazu Matsumoto Yasuki Nakatani Shunji Urai Takeshi Seta Yoshito Uenoyama Yukitaka Yamashita |
| author_facet | Hiroyoshi Iwagami Takuji Akamatsu Kazuki Matsuyama Yusuke Hanawa Kohei Tonomura Eiki Chikugo Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Hisakazu Matsumoto Yasuki Nakatani Shunji Urai Takeshi Seta Yoshito Uenoyama Yukitaka Yamashita |
| author_sort | Hiroyoshi Iwagami |
| collection | DOAJ |
| description | Abstract Objectives Endoscopic submucosal dissection (ESD) is effective for the resection of colorectal intramucosal lesions. This study was performed to examine the safety and effectiveness of using dexmedetomidine (DEX) in the anesthesia regimen of patients with colorectal lesions undergoing ESD. Methods We retrospectively examined 287 consecutive patients who underwent ESD for colorectal lesions in our institution from January 2015 to December 2021. Outcomes including the frequency of intraprocedural pain and adverse events were compared between the DEX and no DEX groups. Moreover, univariate and multivariate analyses were conducted for each clinical factor of intraprocedural pain. Intraprocedural pain was defined as patient‐reported abdominal pain or body movement during the procedure. Results The incidence of intraprocedural pain was significantly lower in the DEX than in the no DEX group (7% vs. 17%, p = 0.02). The incidence of hypotension was also significantly higher in the DEX group (7% vs. 0%, p = 0.01), but no cerebrovascular or cardiac ischemic events occurred. In the univariate analyses, the diameter of the resected specimen, procedure time, no use of DEX, and total midazolam dose was associated with intraprocedural pain. The midazolam dose and DEX administration were significantly negatively correlated and the diameter of resected specimen and procedure time were significantly positively correlated. Multivariate logistic regression showed that no use of DEX was independently associated with intraprocedural pain (p = 0.02). Conclusions Adding DEX to the anesthesia regimen in patients undergoing colorectal ESD appears to be safe and effective for reducing intraprocedural pain. |
| format | Article |
| id | doaj-art-0ccad85ffbe04bf8b4cd9c1110bb51aa |
| institution | OA Journals |
| issn | 2692-4609 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Wiley |
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| series | DEN Open |
| spelling | doaj-art-0ccad85ffbe04bf8b4cd9c1110bb51aa2025-08-20T02:31:29ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.223Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissectionHiroyoshi Iwagami0Takuji Akamatsu1Kazuki Matsuyama2Yusuke Hanawa3Kohei Tonomura4Eiki Chikugo5Shinya Ogino6Hiroki Morimura7Masayuki Shimoyama8Tomoko Terashita9Shogo Nakano10Midori Wakita11Takeya Edagawa12Takafumi Konishi13Hisakazu Matsumoto14Yasuki Nakatani15Shunji Urai16Takeshi Seta17Yoshito Uenoyama18Yukitaka Yamashita19Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center Wakayama JapanAbstract Objectives Endoscopic submucosal dissection (ESD) is effective for the resection of colorectal intramucosal lesions. This study was performed to examine the safety and effectiveness of using dexmedetomidine (DEX) in the anesthesia regimen of patients with colorectal lesions undergoing ESD. Methods We retrospectively examined 287 consecutive patients who underwent ESD for colorectal lesions in our institution from January 2015 to December 2021. Outcomes including the frequency of intraprocedural pain and adverse events were compared between the DEX and no DEX groups. Moreover, univariate and multivariate analyses were conducted for each clinical factor of intraprocedural pain. Intraprocedural pain was defined as patient‐reported abdominal pain or body movement during the procedure. Results The incidence of intraprocedural pain was significantly lower in the DEX than in the no DEX group (7% vs. 17%, p = 0.02). The incidence of hypotension was also significantly higher in the DEX group (7% vs. 0%, p = 0.01), but no cerebrovascular or cardiac ischemic events occurred. In the univariate analyses, the diameter of the resected specimen, procedure time, no use of DEX, and total midazolam dose was associated with intraprocedural pain. The midazolam dose and DEX administration were significantly negatively correlated and the diameter of resected specimen and procedure time were significantly positively correlated. Multivariate logistic regression showed that no use of DEX was independently associated with intraprocedural pain (p = 0.02). Conclusions Adding DEX to the anesthesia regimen in patients undergoing colorectal ESD appears to be safe and effective for reducing intraprocedural pain.https://doi.org/10.1002/deo2.223dexmedetomidineendoscopic submucosal dissectioncolorectalanesthesiasedation |
| spellingShingle | Hiroyoshi Iwagami Takuji Akamatsu Kazuki Matsuyama Yusuke Hanawa Kohei Tonomura Eiki Chikugo Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Hisakazu Matsumoto Yasuki Nakatani Shunji Urai Takeshi Seta Yoshito Uenoyama Yukitaka Yamashita Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection DEN Open dexmedetomidine endoscopic submucosal dissection colorectal anesthesia sedation |
| title | Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| title_full | Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| title_fullStr | Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| title_full_unstemmed | Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| title_short | Dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| title_sort | dexmedetomidine is safe and effective for reducing intraprocedural pain in colorectal endoscopic submucosal dissection |
| topic | dexmedetomidine endoscopic submucosal dissection colorectal anesthesia sedation |
| url | https://doi.org/10.1002/deo2.223 |
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