Remifentanil compared with midazolam and pethidine sedation during colonoscopy: a prospective, randomized study.
OBJECTIVE
The objective of our study was to compare the safety and efficacy of remifentanil during colonoscopy with those of the standard combination of midazolam and pethidine.


METHODS
One-hundred and sixteen consecutive patients scheduled for colonoscopy were randomly assigned to groups A or B. Patients in group A (n = 56) received intravenous (IV) midazolam and pethidine. Patients in group B (n = 60) received IV remifentanil.


RESULTS
Recovery was faster in group B (0 min) than in group A (56 +/- 11.3 min) (P < 0.001). There was a marked difference between groups B and A with regard to the time of hospital discharge-28.7 +/- 4.3 and 148.9 +/- 34 min, respectively (P < 0.001). Patients in group A rated the procedure as comfortable, as also did those in group B. A combination of midazolam and pethidine had a greater affect on patients' cardiorespiratory characteristics.


CONCLUSIONS
Remifentanil during colonoscopy provides sufficient pain relief with better hemodynamic stability, less respiratory depression, and significantly faster recovery and hospital discharge than moderate sedation with midazolam and pethidine.
Manolaraki
Maria M
MM
Department of Anesthesiology, Benizelion General Hospital, Heraklion-Crete, Greece.
Theodoropoulou
Angeliki
A
Stroumpos
Charalampos
C
Vardas
Emmanouil
E
Oustamanolakis
Pantelis
P
Gritzali
Aliki
A
Chlouverakis
Gregorios
G
Paspatis
Gregorios A
GA
D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D017060:Patient Satisfaction; D010880:Piperidines / Q000627:therapeutic use*; D011446:Prospective Studies; D000077208:Remifentanil; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D008874:Midazolam