Sedação e Analgesia em Colonoscopia Eletiva: Propofol-Fentanil versus Propofol-Alfentanil

Türk, Hacer Şebnem; Aydoğmuş, Meltem Türkay; Ünsal, Oya; Köksal, Hakan; Açık, Mehmet Eren; Oba, Sibel

doi:10.1016/j.bjan.2012.07.006

Cited by 9 publications

(3 citation statements)

References 15 publications

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“…With higher doses, hypotension, respiratory depression, and decreased upper airway protective reflex activity can be life-threatening. [ 20 ] Moreover, propofol lacks analgesic properties.…”

Section: Discussionmentioning

confidence: 99%

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Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Sultan

2014

Saudi J Anaesth

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Context:Many techniques are used for sedation of colonoscopies. Patient-controlled sedation (PCS) is utilizing many drugs or drug combinations.Aims:The aim of this study is to compare the safety and feasibility of propofol/remifentanil versus propofol/alfentanil given to sedate patients undergoing outpatient colonoscopies through a patient-controlled technique.Settings and Design:Controlled randomized and double-blind study.Materials and Methods:A total of 80 patients were randomly divided into two groups; PA group received a combination of propofol/alfentanil and PR group received propofol/remifentanil combination. Patients were monitored for heart rate (HR), blood pressure (BP), oxygen saturation, and Ramsay sedation scale (RSS). Times of the following events were recorded; initiation of sedation, insertion and removal of the colonoscope, recovery and discharge. Five intervals were calculated; time to sedation, procedure time, postprocedure time, procedure room time, and postanesthesia care unit (PACU) time. Endoscopist and patient satisfaction scores were obtained.Statistical Analysis Used:Unpaired Student's t-test was used to compare between the two groups. Paired Student's t-test was used to compare baseline readings with readings after 30 min of sedation in the same group when needed.Results:Both groups showed slowing of the HR and decrease in mean arterial BP. HR and mean arterial BP were significantly lower 5 and 10 min after initiation of sedation in PR group when compared with PA group. Both HR and mean arterial BP returned to presedation readings 30 min after initiation of sedation in PR group but not in PA group. No differences between the two groups concerning oxygen saturation, RSS, endoscopist and patient satisfaction scores. Postprocedure and PACU times were significantly prolonged in PA group.Conclusion:PCS with either remifentanil/propofol or alfentanil/propofol for patients undergoing outpatient colonoscopy is safe and feasible. Remifentanil/proofol has more beneficial advantages in this setting secondary to its more rapid clearance.

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Section: Discussionmentioning

confidence: 99%

“…Many opioids were added to propofol with different degrees of success. Fentanyl,[ 20 ] alfentanil,[ 11 12 20 ] sufentanil,[ 22 23 ] and remifentanil[ 10 24 ] were all used. Alfentanil is less lipid soluble than fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Sultan

2014

Saudi J Anaesth

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“…This may be due to the longer acting time of fentanyl, which improves the operation conditions. 28 However, the contrasting results of another study remind us to be vigilant to the respiratory depression caused by fentanyl. 29 Moreover, alfentanil may bind with more affinity to opioid receptors, it has a shorter effect, a small distribution volume, and displays a more rapid effect onset than fentanyl.…”

Section: Discussionmentioning

confidence: 96%

Comparison of the Safety and Efficacy of Remimazolam Besylate versus Dexmedetomidine for Patients Undergoing Fiberoptic Bronchoscopy: A Prospective, Randomized Controlled Trial

Xu,

Wang,

Zhu

et al. 2024

DDDT

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Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using midazolam or fentanyl associated with propofol

Magnus

Flausino²,

Siqueira³

et al. 2020

Journal of Coloproctology

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Objective Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using two drug combinations: midazolam and propofol or fentanyl and propofol. Method Fifty patients ASA I and II, from 18 to 65 years of age, candidates for elective colonoscopy under sedation administered by an anesthesiologist, were randomized in two groups: Group A (midazolam and propofol) and Group B (fentanyl and propofol). Each patient was evaluated as for the length of the exam (Exam length), length of stay in the post-anesthesia care unit 1 and 2 (LSPACU1 and LSPACU2) and hospital discharge. Episodes of awakening, and of movement, drop in SpO2 < 90%, need for mechanical ventilation, propofol consumption, heart rate (HR) and mean blood pressure (MBP) were also evaluated. Results Patients of group B had a recovery time in LSPACU1 statistically shorter than that for those in group A. In both groups, LSPACU1 was considered inversely proportional to LSPACU2. Hospital discharge time was similar between groups. Patients of group B had a significant decrease in MBP during and at the end of the exam, when compared to the initial measurement and that during sedation. Nevertheless, this variation was lower than 20%. No adverse event was observed. All patients were discharged on the same day, with no unexpected hospitalization. Conclusions The combined use of fentanyl and propofol for colonoscopy sedation had a post-anesthesia recovery time in LSPACU1 shorter than that with the combination of midazolam and propofol. Nevertheless hospital discharge time was similar between groups.

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Sedação e Analgesia em Colonoscopia Eletiva: Propofol-Fentanil versus Propofol-Alfentanil

Abstract: Fentanyl provides better operative conditions and reduces the need for additional propofol doses. These advantages cause a shorter recovery time. Therefore, propofol-fentanyl is superior to the propofol-alfentanil for sedation-analgesia in colonoscopy.

Cited by 9 publications

References 15 publications

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Comparison of the Safety and Efficacy of Remimazolam Besylate versus Dexmedetomidine for Patients Undergoing Fiberoptic Bronchoscopy: A Prospective, Randomized Controlled Trial

Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using midazolam or fentanyl associated with propofol

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