Endoscopy 1998; 30(9): 768-773
DOI: 10.1055/s-2007-1001419
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Patient-Controlled Sedation and Analgesia, Using Propofol and Alfentanil, During Colonoscopy: A Prospective Randomized Controlled Trial

C. Roseveare1 , C. Seavell2 , P. Patel1 , J. Criswell2 , J. Kimble1 , C. Jones1 , H. Shepherd1
  • 1Dept. of Medicine, Royal Hampshire County Hospital, Winchester, United Kingdom
  • 2Dept. of Anaesthetics, Royal Hampshire County Hospital, Winchester, United Kingdom
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Abstract

Background and Study Aims: Patient-controlled sedation (PCS) enables titration of dosage to an individual's requirements and is potentially useful in colonoscopy. The aim was to compare the value of patient-controlled sedation, using propofol and alfentanil, with that of intravenous diazemuls and pethidine during colonoscopy.

Patients and Methods: Following randomization, 66 patients undergoing colonoscopy received either an intravenous bolus of pethidine (50 mg) and diazemuls (10 - 20 mg) prior to colonoscopy or were connected to an infusion pump containing propofol (10 mg/ml) and alfentanil (25 µg/ml). Patients self-administered 0.5 ml boluses as often as they required. Pain and sedation score were recorded by a nurse specialist and on a patient questionnaire. An anaesthetist was present throughout the procedure.

Results: PCS provided lighter sedation (median sedation score, 3 versus 4; P = 0.0001), less analgesia (median pain score, 1 versus 0; P = 0.004), a smaller maximum fall in systolic blood pressure (23 mmHg versus 33 mmHg; P = 0.02) and a faster recovery time (median 10 min versus 40 min; P = 0.0001), irrespective of the dose administered, compared with a diazemuls-pethidine combination. The duration of the procedure was unaffected. All patients were satisfied with their level of sedation.

Conclusions: Patient-controlled sedation is an effective alternative to premedication with narcotic/benzodiazepine combinations during colonoscopy.