Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial
Introduction: The choice of anesthetic agents plays a crucial role in procedural success. This study aimed to compare the effects of propofol-fentanyl and propofol-dexmedetomidine combinations, focusing on patient and surgeon perspectives in outpatient procedures. Methods: A randomized, controlled,...
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Elsevier
2025-07-01
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| Series: | Brazilian Journal of Anesthesiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001425000521 |
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| author | Nicole Morem Pilau Moritz Getúlio Rodrigues de Oliveira Filho José Eduardo Moritz Jefferson Luiz Traebert |
| author_facet | Nicole Morem Pilau Moritz Getúlio Rodrigues de Oliveira Filho José Eduardo Moritz Jefferson Luiz Traebert |
| author_sort | Nicole Morem Pilau Moritz |
| collection | DOAJ |
| description | Introduction: The choice of anesthetic agents plays a crucial role in procedural success. This study aimed to compare the effects of propofol-fentanyl and propofol-dexmedetomidine combinations, focusing on patient and surgeon perspectives in outpatient procedures. Methods: A randomized, controlled, triple-blind clinical trial including 128 adult patients undergoing elective outpatient surgical procedures with sedation and local anesthesia. Patients were randomized to receive either propofol-fentanyl (PF, n = 64) or propofol-dexmedetomidine (PDex, n = 64). Primary outcomes were patient satisfaction, assessed using the ISAS-Br score, and the adequacy of sedation, evaluated by the surgeon and measured by a Numerical Rating Scale (NRS) for movement. Respiratory and hemodynamic changes, as well as awakening from anesthesia, adverse events during recovery, and time to hospital discharge were compared. Results: No difference between patient satisfaction scores (median ISAS-Br [IQR]: PF 2.64 [2.45‒3.00] vs. PDex 3.00 [2.45‒3.00], p = 0.252). The PF group had a significantly lower movement score (median NRS [IQR]: 0.5 [0.00‒2.25] vs. 2.0 [0.00‒5.00], p = 0.006). The incidence of intraoperative events related to respiration and hemodynamics, as postoperative pain and postoperative nausea/vomiting were similar. A higher proportion of patients sedated with PF awoke in the operating room (75% vs. 35.9%, p < 0.001), and 98.4% of the PF group vs. 92.2% of the PDex group were ready for hospital discharge in less than thirty minutes, p = 0.208. Conclusion: Single doses of fentanyl or dexmedetomidine combined with propofol resulted in equivalent patient satisfaction, safety, and discharge times. The propofol-fentanyl combination demonstrated superior sedation adequacy from the surgeon’s perspective and facilitated a faster emergence from anesthesia. |
| format | Article |
| id | doaj-art-ea0612f3f9814032a8b4384855d2367e |
| institution | DOAJ |
| issn | 0104-0014 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj-art-ea0612f3f9814032a8b4384855d2367e2025-08-20T02:42:04ZengElsevierBrazilian Journal of Anesthesiology0104-00142025-07-0175484463610.1016/j.bjane.2025.844636Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trialNicole Morem Pilau Moritz0Getúlio Rodrigues de Oliveira Filho1José Eduardo Moritz2Jefferson Luiz Traebert3Hospital Universitário da Universidade Federal de Santa Catarina, Departamento de Anestesia, Florianópolis, SC, Brazil; Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde, Palhoça, SC, Brazil; Corresponding author.Hospital Universitário da Universidade Federal de Santa Catarina, Departamento de Anestesia, Florianópolis, SC, BrazilUltralitho Centro Médico, Florianópolis, SC, BrazilUniversidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde, Palhoça, SC, BrazilIntroduction: The choice of anesthetic agents plays a crucial role in procedural success. This study aimed to compare the effects of propofol-fentanyl and propofol-dexmedetomidine combinations, focusing on patient and surgeon perspectives in outpatient procedures. Methods: A randomized, controlled, triple-blind clinical trial including 128 adult patients undergoing elective outpatient surgical procedures with sedation and local anesthesia. Patients were randomized to receive either propofol-fentanyl (PF, n = 64) or propofol-dexmedetomidine (PDex, n = 64). Primary outcomes were patient satisfaction, assessed using the ISAS-Br score, and the adequacy of sedation, evaluated by the surgeon and measured by a Numerical Rating Scale (NRS) for movement. Respiratory and hemodynamic changes, as well as awakening from anesthesia, adverse events during recovery, and time to hospital discharge were compared. Results: No difference between patient satisfaction scores (median ISAS-Br [IQR]: PF 2.64 [2.45‒3.00] vs. PDex 3.00 [2.45‒3.00], p = 0.252). The PF group had a significantly lower movement score (median NRS [IQR]: 0.5 [0.00‒2.25] vs. 2.0 [0.00‒5.00], p = 0.006). The incidence of intraoperative events related to respiration and hemodynamics, as postoperative pain and postoperative nausea/vomiting were similar. A higher proportion of patients sedated with PF awoke in the operating room (75% vs. 35.9%, p < 0.001), and 98.4% of the PF group vs. 92.2% of the PDex group were ready for hospital discharge in less than thirty minutes, p = 0.208. Conclusion: Single doses of fentanyl or dexmedetomidine combined with propofol resulted in equivalent patient satisfaction, safety, and discharge times. The propofol-fentanyl combination demonstrated superior sedation adequacy from the surgeon’s perspective and facilitated a faster emergence from anesthesia.http://www.sciencedirect.com/science/article/pii/S0104001425000521AnesthesiaDexmedetomidineFentanylOutpatient surgical proceduresPatient satisfactionPropofol |
| spellingShingle | Nicole Morem Pilau Moritz Getúlio Rodrigues de Oliveira Filho José Eduardo Moritz Jefferson Luiz Traebert Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial Brazilian Journal of Anesthesiology Anesthesia Dexmedetomidine Fentanyl Outpatient surgical procedures Patient satisfaction Propofol |
| title | Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial |
| title_full | Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial |
| title_fullStr | Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial |
| title_full_unstemmed | Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial |
| title_short | Propofol-fentanyl versus propofol-dexmedetomidine in outpatient procedures sedation: a triple-blind, randomized controlled clinical trial |
| title_sort | propofol fentanyl versus propofol dexmedetomidine in outpatient procedures sedation a triple blind randomized controlled clinical trial |
| topic | Anesthesia Dexmedetomidine Fentanyl Outpatient surgical procedures Patient satisfaction Propofol |
| url | http://www.sciencedirect.com/science/article/pii/S0104001425000521 |
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