Lidocaine and dexmedetomidine combined infusion as an alternative to propofol for sedation in colonoscopy

Background
Colonoscopy is one of the commonly performed procedures for the diagnosis of colonic disorders. Several sedation regimens are administered during colonoscopy. To date, the propofol-based sedation regimen is commonly used, although it may have some risks. I studied the efficacy of dexmedetomidine–lidocaine combination as a substitution for propofol for sedation in colonoscopy procedures.
Results
Patients in both groups were satisfied by the procedure, and the median and 1st–3rd IQ satisfaction scores were 5 (4.0–5.0) in group P and 4 (4.0–5.0) in group D-L; however, this difference was statistically significant (P value = 0.014), reflecting more satisfaction in patients who received propofol. Patients in group D-L required significantly more doses of midazolam and fentanyl to achieve an adequate sedation score, had a more significant drop in heart rate, and had significantly more postoperative pain scores than those in group P. Patients in group P had significantly more apneic attacks and lower intraprocedural oxygen saturation levels than those in group D-L.
Conclusion
Dexmedetomidine–lidocaine combined IV infusion was found to be effective and safe for sedation in colonoscopy with less side effects in terms of apneic attacks and desaturation, although patient satisfaction was significantly higher in the propofol group, yet as per the sedation scores this was considered to be clinically non-significant.
Trial registration
The study was registered by the Australian New Zealand Clinical Trials Registry (trial ID: ).