Sedation for Colonoscopy: Comparison of Remifentanil and Alfentanil Combined with Propofol/Midazolam

• Published in: Istanbul medical journal 2019-11, Vol.20 (6), p.512-518
• Main Authors: Arıcan, Şule, Çiçekçi, Faruk, Hacıbeyoğlu, Gülçin, Sizer, Çiğdem, Tuncer Uzun, Sema, Dertli, Ramazan, Keskin, Muharrem
• Format: Article
• Language: English
• Subjects: alfentanil; Analgesics; Anesthesia; Blood pressure; Cardiac arrhythmia; Colonoscopy; Drug dosages; Narcotics; Pain; remifentanil; sedation; Software
• ISSN: 2619-9793; 1304-8503; 2148-094X
• DOI: 10.4274/imj.galenos.2019.26566

Introduction: Different drug combinations are used in patients who underwent colonoscopy for safe sedation and early discharge. Remifentanil and alfentanil are short-acting narcotic analgesic agents. A short-acting anxiolytic agent, midazolam has a potent sedative efficiency when combined with narcotic analgesics. In this study, we aimed to compare the effectiveness of the two opioids that have not been previously compared in the literature, combined with propofol/midazolam in patients who underwent colonoscopy. Methods: One hundred eighty-nine patients aged over 18 years who underwent diagnostic and/or therapeutic colonoscopy were included in the study. 1 mg midazolam + 5μg kg-1 alfentanil + 1 mg kg-1 propofol were administered in the alfentanil group (group A), while 1 mg midazolam + 0.1 μg kg-1 min-1 remifentanil + 1 mg kg-1 propofol were administered in the remifentanil group (group R). Hemodynamic data, Modified Steward scale (MSS), Visual Analog scale (VAS), additional propofol doses, total procedure time, awake time, recovery time, and side effects were recorded during the procedure. After the procedure, all patients were transferred to the recovery room, and the Modified Aldrete scale (MAS) values were recorded. Results: There was a statistically significant difference between the groups in terms of total propofol and additional propofol doses (p