Curating and providing a safe and effective anesthetic plan is at the forefront of anesthesiology. Monitored anesthesia care (MAC) is a vital option depending on factors such as the type of surgery and patient comorbidities. MAC can be delivered using a variety of techniques commonly including GABA-agonists, opioids, benzodiazepines, alpha-2 agonists (Barash, 2017). It is the role of the anesthesia provider to provide the best anesthetic portfolio for the patient (American Society of Anesthesiologists, 2018). Dexmedetomidine provides sedation, analgesia, and anti-anxiety effects (Lee, 2019). It preserves respiratory function which is ideal without a secured airway (Parikh, 2013). However, decreases heart rate and mean arterial pressure (Parikh, 2013). Widely used GABA agonist, propofol, is a central nervous system depressant and sedative hypnotic with rapid onset and short duration of action (Miller & Pardo, 2011). Propofol decreases preload and afterload thereby decreasing blood pressure (Vakil, 2017). A comprehensive literature review was completed using Cochran, CINAHL and Google Scholar databases. Eligible studies were selected following PRISMA guidelines as the theoretical framework. Study specific and data outcome tables systematically analyzed study results. Next, studies were critically evaluated utilizing the Critical Appraisal Skills Programme (CASP) checklist. Finally, a cross study analysis table was constructed. The ultimate findings of this systematic review concluded there are no significant differences in hemodynamics between dexmedetomidine or propofol administration for MAC cases. However, five studies report significantly higher satisfaction scores from both the patient and proceduralist perspective when using propofol versus dexmedetomidine. Whereas two trials report greater satisfaction using dexmedetomidine.
