Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer

Abstract Background and Aim Although no specific sedation recommendations exist in early‐stage gastric cancer (ESGC) for endoscopic submucosal dissection (ESD), dexmedetomidine (DEX) is useful along with benzodiazepines and analgesics. Furthermore, DEX is used for endoscopic treatment requiring leng...

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Main Authors: Erika Yoshida, Yorimasa Yamamoto, Misako Tohata, Kuniyo Gomi, Tadashi Okayasu, Masatsugu Nagahama
Format: Article
Language:English
Published: Wiley 2024-05-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.13065
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author Erika Yoshida
Yorimasa Yamamoto
Misako Tohata
Kuniyo Gomi
Tadashi Okayasu
Masatsugu Nagahama
author_facet Erika Yoshida
Yorimasa Yamamoto
Misako Tohata
Kuniyo Gomi
Tadashi Okayasu
Masatsugu Nagahama
author_sort Erika Yoshida
collection DOAJ
description Abstract Background and Aim Although no specific sedation recommendations exist in early‐stage gastric cancer (ESGC) for endoscopic submucosal dissection (ESD), dexmedetomidine (DEX) is useful along with benzodiazepines and analgesics. Furthermore, DEX is used for endoscopic treatment requiring lengthy sedation. However, it is unclear which patients should be administered DEX. We examined the factors that determine when DEX should be added for sedation during ESD for ESGC. Methods Of 316 patients undergoing ESD for ESGC at our hospital between January 2017 and December 2020, we examined 310 receiving intravenous anesthesia. Preoperative patient factors and treatment outcomes were retrospectively examined according to the sedation method. Results Among patients with ESGC undergoing ESD at our hospital, DEX was more frequently used alongside sedation in men, those undergoing gastrectomy, those with a lesion diameter ≥20 mm, and those with preoperative ulcers. In the standard group, patients whose treatment duration exceeded 120 min typically had a lesion diameter ≥20 mm, preoperative ulcers, lesions located outside the L region, and were treated by junior physicians. Conclusion It is important to evaluate specific preoperative factors (lesion diameter ≥20 mm, preoperative ulcers, lesion located outside the L region, and having a junior physician as the treating physician) in patients undergoing ESD for ESGC to determine whether the combined use of DEX in sedation is necessary.
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spelling doaj-art-23cc3dce388946df9626de5b4dbb6bb82025-08-20T03:28:19ZengWileyJGH Open2397-90702024-05-0185n/an/a10.1002/jgh3.13065Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancerErika Yoshida0Yorimasa Yamamoto1Misako Tohata2Kuniyo Gomi3Tadashi Okayasu4Masatsugu Nagahama5Division of Gastroenterology Showa University Fujigaoka Hospital Yokohama JapanInternal Medicine Hitachi Zosen Health Insurance Union, Innoshima General Hospital Hiroshima JapanDivision of Gastroenterology Showa University Fujigaoka Hospital Yokohama JapanDivision of Gastroenterology Showa University Fujigaoka Hospital Yokohama JapanAnesthesiology Showa University Fujigaoka Hospital Yokohama JapanDivision of Gastroenterology Showa University Fujigaoka Hospital Yokohama JapanAbstract Background and Aim Although no specific sedation recommendations exist in early‐stage gastric cancer (ESGC) for endoscopic submucosal dissection (ESD), dexmedetomidine (DEX) is useful along with benzodiazepines and analgesics. Furthermore, DEX is used for endoscopic treatment requiring lengthy sedation. However, it is unclear which patients should be administered DEX. We examined the factors that determine when DEX should be added for sedation during ESD for ESGC. Methods Of 316 patients undergoing ESD for ESGC at our hospital between January 2017 and December 2020, we examined 310 receiving intravenous anesthesia. Preoperative patient factors and treatment outcomes were retrospectively examined according to the sedation method. Results Among patients with ESGC undergoing ESD at our hospital, DEX was more frequently used alongside sedation in men, those undergoing gastrectomy, those with a lesion diameter ≥20 mm, and those with preoperative ulcers. In the standard group, patients whose treatment duration exceeded 120 min typically had a lesion diameter ≥20 mm, preoperative ulcers, lesions located outside the L region, and were treated by junior physicians. Conclusion It is important to evaluate specific preoperative factors (lesion diameter ≥20 mm, preoperative ulcers, lesion located outside the L region, and having a junior physician as the treating physician) in patients undergoing ESD for ESGC to determine whether the combined use of DEX in sedation is necessary.https://doi.org/10.1002/jgh3.13065dexmedetomidineearly‐stage gastric cancerendoscopic submucosal dissection
spellingShingle Erika Yoshida
Yorimasa Yamamoto
Misako Tohata
Kuniyo Gomi
Tadashi Okayasu
Masatsugu Nagahama
Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
JGH Open
dexmedetomidine
early‐stage gastric cancer
endoscopic submucosal dissection
title Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
title_full Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
title_fullStr Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
title_full_unstemmed Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
title_short Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early‐stage gastric cancer
title_sort determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early stage gastric cancer
topic dexmedetomidine
early‐stage gastric cancer
endoscopic submucosal dissection
url https://doi.org/10.1002/jgh3.13065
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