内視鏡治療時のデクスメデトミジン投与による血圧低下発現の要因

抄録

Recently, dexmedetomidine (DEX) has been used for endoscopic sedation. Conversely, hypotension has been reported to occur with DEX. However, the presence or degree of hypotension is variable, with adverse events, such as sedation, interfering with endoscopy. This study investigated the predictive factors related to DEX-associated hypotension for safe sedation with DEX during endoscopy. This retrospective study was conducted among 234 patients who had been administered DEX for sedation during endoscopy between January 2017 and December 2018 at Hiroshima City Hiroshima Citizens Hospital. Hypotension is defined as a decrease in systolic blood pressure ≥30％ from baseline. In this study, hypotension was reported in 149 of the 243 analyzed patients, resulting in an incidence of 63.7％. The results of the multivariate analysis demonstrated that body weight was associated with DEX-associated hypotension. Notably, the median body weight of the DEX-associated hypotension group was less than that observed in the DEX-associated non-hypotension group. Furthermore, based on the results of the receiver operating curve analysis, we observed that patients weighing less than 58.1 kg may be more likely to report DEX-associated hypotension when administered DEX during endoscopy. Hence, we revealed the predictive factor of DEX-associated hypotension in endoscopy, which could contribute to the safe use of DEX in endoscopy.