Patient Satisfaction of Propofol Versus Midazolam and Fentanyl Sedation During Colonoscopy in Inflammatory Bowel Disease

Steenholdt, Casper; Jensen, Jeppe Thue; Brynskov, Jørn; Møller, Ann Merete; Limschou, Anne Christine; Konge, Lars; Vilmann, Peter

doi:10.1016/j.cgh.2020.10.037

Cited by 20 publications

(15 citation statements)

References 23 publications

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“…In our study, we adopted deep sedation (MOAA/S ≤1 during the gastroscopy operation) for the following reasons: (i) Deep sedation is more often adopted in Chinese endoscopic procedures than moderate sedation. Also, in clinical settings, the desire for deeper levels of sedation (mainly propofol‐based) has grown with the increasing complexity of endoscopic procedures and rapidly gaining popularity 23–25 . (ii) It is to better identify the safety of remimazolam under the same sedation depth as propofol, which is likely to result in unplanned deep sedation 6 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial

et al. 2023

Brit J Clinical Pharma

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AimsAdvanced age is an important risk factor for adverse events during procedural sedation. Remimazolam is safe and effective in gastroscopic sedation. However, the ideal dose and application for older patients are not well known. We aim to investigate its 95% effective dose (ED95) for older patients undergoing gastroscopy and to assess its safety and efficacy, with propofol as the comparison.MethodsThe trial consists of 2 parts, patients aged >65 years and scheduled for outpatient painless gastroscopy were enrolled. In the first part, Dixon's up‐and‐down methodology was used to determine the ED95 of remimazolam besylate and propofol for gastroscopic insertion, in combination with 0.2 μg/kg remifentanil. In the second part, patients in each group received 0.2 μg/kg remifentanil and ED95 dose of the study drugs for sedation induction, supplemental doses were added to maintain sedation depth when necessary. The primary outcome was the incidence of adverse events. The secondary outcome was the recovery time.ResultsThe ED95 of remimazolam besylate and propofol induction were 0.2039 (95% confidence interval 0.1753–0.3896) mg/kg and 1.9733 (95% confidence interval 1.7346–3.7021) mg/kg respectively. Adverse events were reported in 26 (40.6%) patients in the remimazolam group and 54 (83.1%) in the propofol group (P < .0001), whereas the remimazolam group presented a higher incidence of hiccups (P = .0169). Besides, the median time to awakening was approximately 1 min shorter with remimazolam than with propofol (P < .05).ConclusionFor older patients undergoing gastroscopy, the ED95 dose of remimazolam is a safer alternative than propofol when inducing the same sedation depth.

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Section: Discussionmentioning

confidence: 99%

Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial

et al. 2023

Brit J Clinical Pharma

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“…In addition, patients who underwent polyp resection during colonoscopy had similar median VAS scale with others. It was reported that patients with inflammatory bowel disease favored propofol sedation over conscious sedation ( 16 ). Moreover, IBD patients ( n = 15) presented similar outcomes compared to non-IBD patients ( n = 137) in our study ( P = 0.75).…”

Section: Discussionmentioning

confidence: 99%

“…The latter method could induce a deeper level of sedation with less patient movement and awareness. However, deep sedation colonoscopy is associated with higher cost and greater risk of sedation- and procedure-related complications ( 16 ). Furthermore, modified anesthesia can only be performed by an anesthesiologist, which is one of the main reasons for the lower sedation rate in China, compared to the United States and Europe ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Choice of injection time of conscious sedation and its impact on pain control in colonoscopy

Chen²,

Zhong³

et al. 2022

Front. Surg.

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PurposeThe aim of this study was to identify the effect of different injection times on pain during colonoscopy procedure.MethodsIn this retrospective study, the data of patients who underwent colonoscopy from June 2020 to September 2020 were assessed to investigate the effect of different injection time of sedative drugs (midazolam and dezocine). The primary endpoint was evaluating the pain intensity of the patients using visual analogue scale (VAS) immediately after colonoscopy .ResultsA total of 152 patients were eligible for this study. Of them, 76 received midazolam and dezocine injection 1 min prior to the colonoscopy procedure (the 1 Min group) and the other 76 patients received the injection 3 min prior to the procedure (the 3 Min group). The vital signs of all patients were stable except for one patient who was diagnosed with inflammatory bowel disease in the 3 Min group. A transient drop in blood pressure for this patient was observed during colonoscopy but returned to normal after general treatment. The two groups had similar rates of cecal intubation (84.21% vs. 90.97%, P = 0.22), addition of sedative drugs during procedure (2.63% vs. 5.26%, P = 0.68), and adequate bowel preparation (Boston Bowel Preparation Scale ≥6, 61.84% vs. 61.84%, P = 1.0). However, patients in the 3 Min group had significantly lower VAS than those in the 1 Min group [0 (0, 1) vs. 1 (0, 2), P = 0.041].ConclusionThe timing of drug injection during conscious sedation may affect pain control during colonoscopy, with 3 min prior to the procedure showing lower VAS.

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“…We thank Dr Vaughn for interest in our recent study. 1 Colonoscopy is pivotal for optimal management of patients with inflammatory bowel disease (IBD), but tolerability is low and patients often opt out because of unpleasantness of the procedure. To explore ways of meeting this immense challenge, we investigated in a randomized controlled trial if deep propofol sedation would improve patient satisfaction as compared with conventional moderate sedation with midazolam and fentanyl.…”

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Steenholdt

Brynskov

Vilmann

2022

Clinical Gastroenterology and Hepatology

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Patient Satisfaction of Propofol Versus Midazolam and Fentanyl Sedation During Colonoscopy in Inflammatory Bowel Disease

Cited by 20 publications

References 23 publications

Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial

Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial

Choice of injection time of conscious sedation and its impact on pain control in colonoscopy

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