Sedation-Analgesia in Elective Colonoscopy: Propofol-Fentanyl Versus Propofol-Alfentanil

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

doi:10.1016/j.bjane.2012.07.007

Cited by 14 publications

(15 citation statements)

References 15 publications

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“…Further research on how symptomatic patients experience CCE and OC are needed and should include the clinical hospital setting with deep propofol sedation during OC. Screening individuals seem to have a high satisfaction with this [30], and also higher than individuals in moderate sedation [31], which our participants received during the OC.…”

Section: Discussionmentioning

confidence: 76%

Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

et al. 2019

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Background: The standard investigation in colorectal cancer screening (optical colonoscopy [OC]) has a less invasive alternative with the colon capsule endoscopy (CCE). The experiences of screening individuals are needed to support a decision aid (DA) and to provide a patient view in future health technology assessments (HTA). We aimed to explore the experiences of CCE at home and OC in an outpatient clinic by screening participants who experienced both investigations on the same bowel preparation. Methods: In a mixed methods study, Danish screening individuals with a positive immunological fecal occult blood test (FIT) were consecutively included and underwent both CCE and OC in the same bowel preparation. They answered questionnaires about discomfort during CCE, delivered at home, and during a following OC in the outpatient clinic. Data were calculated in percentages and Wilcoxon signed rank test was used for comparisons. Among the 253 included patients, 10 participants were selected for a semi-structured interview about their experiences of the two examinations. The analysis and interpretation of the transcribed data were inspired by Ricoeur. Results: Questionnaire data were received from 239 participants and revealed significant less discomfort during the CCE than the OC. Interview data included explained discomfort elements in two categories: 'The examination' and 'The setting'. Compared to OC, the CCE was experienced with less pain, embarrassment and invasiveness, but presented challenges and disadvantages as well, i.e., a large camera capsule to swallow, a longer waiting time for test results after CCE and an additional OC, if pathologies were found. The home setting for CCE delivery made the participants feel less like they were ill or patients less restricted and that they received more personal care, but could induce technical challenges. MethodsA mixed methods design was chosen in order to obtain as comprehensive knowledge as possible. Within a cohort study

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Section: Discussionmentioning

confidence: 76%

Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

et al. 2019

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“…Recently ETCO 2 measuring has become a part of routine monitoring and capnographs are commonly used in operation theaters and intensive care units (7)(8)(9). Capnographic monitoring also prevents redundant blood gas analyses, thus reduces unnecessary costs (9).…”

Section: Discussionmentioning

confidence: 99%

“…Sedation is given in the endoscopy units for gastroscopy and colonoscopy procedures and patient's recovery is usually monitored with SpO 2 (8). ETCO 2 , which is the most important value in assessing ventilation, is not monitored routinely during sedation.…”

Section: Discussionmentioning

confidence: 99%

Safety of Microstream Capnography Monitoring in Patients Under Sedation for Colonoscopy

Oba¹,

Türk²,

Işıl³

et al. 2019

Haseki

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The purpose of this study was to investigate the effectiveness of micro stream capnography in early recognition of adverse events during sedation for colonoscopy. Methods: This prospective randomized study was performed implemented on 82 adults scheduled for elective colonoscopy. SpO 2 , ETCO 2 and integrated pulmonary index (IPI) values were measured with the use of micro stream capnography and recorded. Arterial blood gas samples were taken at the beginning, 10 th minute and end of the procedure and analyzed. Results: The correlation between mean values of IPI and mean values of ETCO 2 , SpO 2 and PaCO 2 was not statistically significant. There was a statistically significant correlation between IPI value at the beginning and PaCO 2 value at the end of the procedure. Correlation of IPI value at the 10th minute with SpO 2 at the 10 th minute and SPO 2 value at the end of the procedure was statistically significant. Conclusion: Non-invasive ETCO 2 monitoring with micro stream capnography is correlated with PaCO 2 values in arterial blood gas analysis, which is useful for monitoring of sedation and hypoventilation during colonoscopy procedures. However, IPI monitoring is not of clinical benefit to early recognition of hypoventilation. Non-invasive ETCO 2 monitoring with micro stream capnography should be a part of routine monitoring for safe anesthetic practice outside the operating room.

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“…Contrary to this, our data revealed less cognitive deterioration with propofol-alfentanil, which can be explained by the utilization of an opioid with a lower dose and shorter half-life. In a similar manner, Türk et al (35) compared propofol-fentanyl and propofol-alfentanil in 80 patients undergoing sedation during colonoscopy and found that propofol-fentanyl provides better operating conditions and shortens the recovery time and is thus more advantageous. The better recovery conditions provided by propofol-alfentanil in our study can be explained by the fact that propofol was used as an infusion.…”

Section: Discussionmentioning

confidence: 99%

“…Bispectral index values and vital signs were recorded every minute for the first 10 min after induction of sedation and then at 15,20,25,30,35,40, and 45 min. Pain during the procedure was evaluated using the FPS (0-6), whereas pain after the procedure was evaluated using visual analogue scale (VAS) (0-10) at 5, 15, and 30 min after the procedure.…”

Section: Methodsmentioning

confidence: 99%

Effects of alfentanil or fentanyl added to propofol for sedation in colonoscopy on cognitive functions: Randomized controlled trial

Doğanay

Ekmekçi²,

Kazbek³

et al. 2017

Turk J Gastroenterol

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Sedation-Analgesia in Elective Colonoscopy: Propofol-Fentanyl 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 14 publications

References 15 publications

Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

Safety of Microstream Capnography Monitoring in Patients Under Sedation for Colonoscopy

Effects of alfentanil or fentanyl added to propofol for sedation in colonoscopy on cognitive functions: Randomized controlled trial

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