Comparison of etomidate-remifentanil and propofol-remifentanil sedation in patients scheduled for colonoscopy.
OBJECTIVE
The aim of the study was to compare haemodynamic responses, recovery and discharge times, and physician satisfaction of etomidate-remifentanil and propofol-remifentanil combinations in patients undergoing elective colonoscopy.


METHODS
Sixty patients, aged 18-65 years, scheduled for elective colonoscopy under sedation were prospectively randomized, double blind for the study. Two minutes after the beginning of a continuous remifentanil infusion (0.1 microg kg(-1) min(-1)), etomidate or propofol were administered. Patients in the etomidate group received a 0.05 mg kg(-1) maintenance dose of etomidate after an initial dose of 0.1 mg kg(-1), and patients in the propofol group received a 0.25 mg kg(-1) maintenance dose of propofol after an initial dose of 0.5 mg kg(-1) in order to have a Ramsay sedation score of 3-4. Basal values of heart rate, mean arterial pressure, oxygen saturation, respiratory rate and Ramsay sedation score were recorded. Values were recorded every 2 min for the first 10 min and every 5 min thereafter, until the completion of the procedure.


RESULTS
Mean arterial pressure was lower at 4, 6, 8, 10, 15, 20 and 25 min in the propofol group (P = 0.001). Mean respiratory rate in the propofol group at 6, 8, 10, 15, 20, 25 min was also lower (P < 0.05). The incidence of apnoea and hypotension was significantly lower in the etomidate group (P < 0.001). Arrival time into the postoperative care unit and recovery time were shorter in the etomidate group (P = 0.001, P = 0.01, respectively). Physician satisfaction in both groups was similar.


CONCLUSIONS
Etomidate-remifentanil administration for sedation and analgesia during colonoscopy resulted in more stable haemodynamic responses and shorter recovery and discharge times.
Toklu
Salime
S
Department of Anesthesiology, Dokuz Eylul University, Izmir, Turkey.
Iyilikci
Leyla
L
Gonen
Can
C
Ciftci
Lugen
L
Gunenc
Ferim
F
Sahin
Elvan
E
Gokel
Erol
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003113:Colonoscopy / Q000379:methods; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005045:Etomidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D000077208:Remifentanil; D012119:Respiration / Q000187:drug effects; D055815:Young Adult
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol; D005045:Etomidate