The comparison of dexmedetomidine and midazolam used for sedation of patients undergoing upper gastrointestinal endoscopy

Background: Endoscopic procedures are vital for diagnosing and treating various conditions but can cause significant discomfort and pain. Sedation is essential to minimize pain, mobility, gagging, and nausea while maintaining respiratory and cardiovascular stability. This study compares the efficacy and safety of Midazolam and Dexmedetomidine in sedation, focusing on patient and endoscopist satisfaction, recovery time, and adverse effects during upper endoscopy. Methodology: A prospective observational study was conducted on 68 patients (ages 18–60) classified as ASA grades I or II. The study took place at An-Najah National University Hospital, Nablus, Palestine, from October 2021 to January 2022. Participants were informed about the study's purpose, protocol, and consent process, and written consent was obtained. Results: Dexmedetomidine showed significantly higher patient and endoscopist satisfaction, faster recovery times, and less discomfort and anxiety compared to Midazolam (p<0.05). Patients sedated with Dexmedetomidine recovered more quickly, with a mean recovery time of 9.5 ± 1.1 minutes compared to 22.4 ± 7.7 minutes for Midazolam, demonstrating a statistically significant advantage (p<0.05). While Dexmedetomidine had fewer side effects, the difference was not statistically significant. No significant differences in vital signs were observed between the two groups. Conclusions: Dexmedetomidine outperformed Midazolam in recovery time, patient satisfaction, endoscopist satisfaction, and minimizing discomfort, anxiety, and retching. It presents a safe and effective alternative to Midazolam for sedation during upper endoscopy.