Dexmedetomidine - Oxycodone Combination for Conscious Sedation during Colonoscopy in Obese Patients: A Randomised Controlled Trial

Abstract What Is Known and Objective: Obesity is a risk factor for sedation related respiratory depression during colonoscopy. Propofol has potent sedative and hypnotic effects and has been widely used in colonoscopy. However, propofol is associated with marked respiratory depression. The objective of this trial was to investigate the effectiveness and safety of dexmedetomidine plus oxycodone for conscious sedation during colonoscopy in obese patients. Methods: A total of 138 patients undergoing colonoscopy were randomly assigned into one of two groups: group Dex+oxy received sedation with dexmedetomidine plus oxycodone; while group Pro+oxy received anaesthesia with propofol plus oxycodone. Parameters including blood pressure, heart rate, respiration, blood oxygen saturation, injection pain, and recovery were recorded for both groups. Results: The incidence of hypoxaemia was significantly reduced in group Dex+oxy compared with group Pro+ oxy (4.9% vs 20.3%, P = 0.011). Blood pressure was significantly increased, and heart rate was reduced in group Dex+oxy compared with group Pro+ oxy (P < 0.05). Moreover, the caecal insertion time, recovery time to orientation, and recovery time to walking were significantly reduced in group Dex+oxy compared with group Pro+ oxy (P < 0.05). Endoscopist satisfaction scores were significantly higher in group Dex+oxy compared with group Pro+ oxy (P = 0.042). What Is New and Conclusion: Dexmedetomidine plus oxycodone provides effective sedation with minimal adverse effects for obese patients, while also reducing colonoscopy operation difficulty by allowing obese patients to reposition. Thus, dexmedetomidine plus oxycodone could be used safely as a conscious sedation method for colonoscopy in obese patients.Trial registration: The protocol was registered at www.chictr.org.cn (ChiCTR1800017283, 21/07/2018)