A Comparison of Dexmedetomidine and Propofol in Patients Undergoing Electrophysiology Study
Naruemol Prachanpanich MD*, Worapot Apinyachon MD*, Wichai Ittichaikulthol MD*, Orawan Moontripakdi MD*, Amporn Jitaree MD*
Affiliation : * Department of Anesthesiology Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
Background : Dexmedetomidine provides profound levels of sedation without affecting cardiovascular and respiratory
stability based on its pharmacological profile. It may be a valuable sedative for procedures with minimal to mild pain.
Electrophysiology study (EP study) is a mildly painful procedure that requires conscious sedation. The authors hypothesized
that dexmedetomidine would cause lower respiratory and cardiovascular depression than propofol during equal sedation
level in an electrophysiology study.
Material and Method: The present study protocol was approved by the clinical research ethics committee at Ramathibodi
Hospital. Thirty-four patients were randomly allocated into two groups to receive either dexmedetomidine or propofol for
an electrophysiology study. Patients in the dexmedetomidine group received a loading dose of dexmedetomidine (0.5 mcg/kg)
infused over 10 minutes followed by 0.4 mcg/kg/h. Each patient in the propofol group received propofol 1mg/kg over
10 minutes followed by 3mg/kg/h. All patients received pethidine (0.5 mg/kg) before the initiation of EP study. Sedation was
determined using the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S). The Modified Observer’s Assessment
of Alertness/Sedation scores, hemodynamic and respiratory variables were recorded regularly during the EP study.
Results : Thirty-four patients were enrolled in the present study. The Modified Observer’s Assessment Alertness/Sedation
values were similar in both groups. Respiratory rate values with dexmedetomidine were significantly higher than those in
the propofol group (p = 0.048) and the oxygen supplement in the dexmedetomidine group were significantly lower than
those in the propofol group (p<0.001). Moreover, mean arterial blood pressure values of dexmedetomidine at the five and
15-minute were significantly higher than those of the propofol group (p = 0.024). No incidence of severe bradycardia or
hypotension was found in both groups.
Conclusion : The present study demonstrated that comparable sedation could be achieved by a combination of pethidine
with either dexmedetomidine or propofol during EP study. Dexmedetomidine group provided more hemodynamic and
respiratory stability than propofol group.
Keywords : Dexmedetomidine, Propofol, Electrophysiology study
