{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:10:55Z","timestamp":1768446655192,"version":"3.49.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Benzodiazepines (BZDs) and analgesics are widely used for conscious sedation during endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP). However, endoscopic procedures are sometimes discontinued because of BZD-induced disinhibitory reactions such as excessive movement. We evaluated the usefulness of dexmedetomidine (DEX) for BZD-induced disinhibition in ERCP. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Between February 2018 and August 2019, 22 patients who underwent EUS or ERCP were enrolled. All patients showed BZD-induced excessive movement at the first examination (BZD group) and received DEX at the second examination (DEX group). The initial DEX dose was 6\u2009\u03bcg\/kg\/h for a 10-min loading, followed by 0.4\u2009\u03bcg\/kg\/h during the procedure. BZDs and analgesics were administered before scope insertion. An additional sedative was administered to achieve a Ramsay sedation scale (RSS) of 4\u20135. Sedative effect, procedure completion rate, and changes in circulatory and respiratory dynamics were evaluated. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Mean RSS scores were significantly higher ( p\u2009&lt;\u20090.001) in the DEX (5.1\u2009\u00b1\u20090.5) compared with the BZD (4.0\u2009\u00b1\u20090.5) group. The movement score ( p\u2009&lt;\u20090.001) and number of additional sedatives required ( p\u2009&lt;\u20090.01) were lower in the DEX group. The procedure completion rate was significantly higher in the DEX (95.5%) compared with the BZD group (63.6%; p\u2009&lt;\u20090.05). Significant differences in the frequency of hypotension ( p\u2009=\u20091.00), bradycardia ( p\u2009=\u20090.22), and respiratory depression ( p\u2009=\u20090.68) were not noted between groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The addition of DEX to BZD therapy yielded better sedative efficacy, lower excessive movement, a reduction in BZDs used, and a higher procedure complete rate. DEX may be used as an alternative method for BZD-induced inhibition during ERCP. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1756284820911822","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T11:11:16Z","timestamp":1588072276000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of combination therapy with dexmedetomidine for benzodiazepines-induced disinhibition during endoscopic retrograde cholangiopancreatography"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7371-8326","authenticated-orcid":false,"given":"Yuki","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuma","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyuki","family":"Murase","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohichi","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Miyanishi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayoshi","family":"Kobune","sequence":"additional","affiliation":[{"name":"Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junji","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,4,28]]},"reference":[{"key":"bibr1-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00500.x"},{"key":"bibr2-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.002"},{"key":"bibr3-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.41672.x"},{"key":"bibr4-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.00320.x"},{"key":"bibr5-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282cf5167"},{"key":"bibr6-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(94)70020-6"},{"key":"bibr7-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.56"},{"key":"bibr8-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1017\/S0265021507001317"},{"key":"bibr9-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2010.01080.x"},{"key":"bibr10-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/350279"},{"key":"bibr11-1756284820911822","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.126782"},{"key":"bibr12-1756284820911822","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1358909"},{"key":"bibr13-1756284820911822","first-page":"119","volume":"57","author":"Inatomi 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