title: Value of fentanyl in flexible sigmoidoscopy.
abstract: Studies have recorded significant patient discomfort during flexible sigmoidoscopy when it is performed without sedation/analgesia. This study observed whether a single dose of 50 mcg intravenous fentanyl reduces pain, improving compliance, acceptability, and completion rates. In a prospective study, 109 consecutive patients were offered the option of 50 mcg intravenous fentanyl or no analgesia. Patient's pre-procedure expectations, objective pain scores, and willingness to undergo a subsequent procedure using the same technique were recorded. Endoscopist recorded the success, complications, and objective pain scores for each patient. Of the 46 patients (42%) choosing fentanyl, 9 (20%) experienced moderate/severe pain as against 26 (41%) of the 63 patients (58%) opting for no analgesia (p < 0.05). Further, 52% receiving fentanyl had a significantly better experience compared to their pre-procedure expectations as against 33% who received no analgesia (p < 0.05). No patient receiving fentanyl expressed unwillingness to undergo the procedure again using the same technique, whereas 16 (25%) of those receiving no analgesia indicated they would not (p < 0.01). Endoscopists recorded moderate/severe pain in 13 patients (12%), whereas 35 patients (32%) recorded moderate/severe pain (p < 0.001). Analgesia for endoscopy should involve patient choice. However, a single dose of 50 mcg fentanyl reduced patient discomfort and improved satisfaction. It appeared safe and likely to improve patient compliance and acceptability for flexible sigmoidoscopy.
authors.affiliation: Endoscopy Unit, St Mary's Hospital, PO30 5TG Isle of Wight, UK. sanjoy000@aol.com
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Basu
authors.forename: Badri
authors.initials: B
authors.lastname: Krishnamurthy
authors.forename: Tim H
authors.initials: TH
authors.lastname: Walsh
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care; D011446:Prospective Studies; D012812:Sigmoidoscopy / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl