title: Propofol versus remifentanil for monitored anaesthesia care during colonoscopy.
abstract: OBJECTIVE
  We conducted an open, prospective, randomized study to compare the efficacy, safety and recovery characteristics of remifentanil or propofol during monitored anaesthesia care in patients undergoing colonoscopy.
  
  
  METHODS
  Forty patients were randomly assigned to receive either propofol (1 mg kg(-1) followed by 10 mg kg (-1) h(-1), n = 20) or remifentanil (0.5 microg kg(-1) followed by 0.2 microg kg(-1) min(-1), n = 20). The infusion rate was subsequently adapted to clinical needs.
  
  
  RESULTS
  In the propofol group, arterial pressure and heart rate decreased significantly from the baseline. These variables remained unchanged in the remifentanil group, but hypoventilation occurred in 55% of patients. Early recovery was delayed in the propofol group (P < 0.002). Recovery of cognitive and psychomotor functions was faster in the remifentanil group. Fifteen minutes after anaesthesia, the Digit Symbol Substitution Test score was 28.6 +/- 12.8 versus 36.2 +/- 9.4 and the Trieger Dot Test score was 25.6 +/- 8.1 versus 18.7 +/- 4.1 in the propofol and remifentanil groups, respectively (both P < 0.05). Patient satisfaction, using a visual analogue scale, was higher in the propofol group (96 +/- 7 versus 77 +/- 21, P < 0.001).
  
  
  CONCLUSIONS
  Remifentanil proved efficient in reducing pain during colonoscopy. Emergence times were shorter and the recovery of cognitive function was faster with remifentanil compared with propofol. Remifentanil provided a smoother haemodynamic profile than propofol; however, the frequent occurrence of remifentanil-induced hypoventilation requires the cautious administration of this agent.
authors.affiliation: Department of Anaesthesia, Ghent University Hospital, Gent, Belgium. annelies.moerman@rug.ac.be
authors.forename: A T
authors.initials: AT
authors.lastname: Moerman
authors.forename: L A
authors.initials: LA
authors.lastname: Foubert
authors.forename: L L
authors.initials: LL
authors.lastname: Herregods
authors.forename: M M R F
authors.initials: MM
authors.lastname: Struys
authors.forename: D J
authors.initials: DJ
authors.lastname: De Wolf
authors.forename: D A
authors.initials: DA
authors.lastname: De Looze
authors.forename: M M
authors.initials: MM
authors.lastname: De Vos
authors.forename: E P
authors.initials: EP
authors.lastname: Mortier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000758:Anesthesia / Q000379:methods; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010880:Piperidines / Q000627:therapeutic use*; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects; D000077208:Remifentanil; D012119:Respiration / Q000187:drug effects
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol