Patient-controlled analgesia and sedation with alfentanyl versus fentanyl for colonoscopy: a randomized double blind study.
OBJECTIVE
The aim of this study was to evaluate whether sedo-analgesia with alfentanyl/fentanyl, using a patient-controlled analgesia (PCA) pump, may have positive outcomes in terms of safety, postprocedural workload, and expectations of the colonoscopist, nurse, and patients in elective colonoscopy.


METHODS
One hundred American Society of Anesthesiology physical status I and II adult patients.


METHODS
Patients were randomized in a double-blind trial to receive either alfentanyl (n=50) or fentanyl (n=50) by PCA, and incremental doses of midazolam.


METHODS
Patient expectations were assessed using hemodynamic variables, willingness to have a repeat colonoscopy in the same way, adverse events, discomfort scores, and patient/operator/nurse satisfaction associated with sedo-analgesia.


RESULTS
All patients in both groups had adequate sedo-analgesia with high satisfaction and willingness scores. There were no serious adverse effects and except for a few events, no required medication. The total sedation times were shorter in the alfentanyl group compared with the fentanyl group.


CONCLUSIONS
PCA and sedation with alfentanyl and fentanyl for colonoscopy are safe, feasible, and acceptable to most patients. However, shorter sedation times make alfentanyl more attractive for postprocedural workload.
Department of Anesthesiology, Fatih University School of Medicine, Ankara, Turkey. drfbusta@yahoo.com
Burhanettin
B
Usta
Cansel
C
Türkay
Bünyamin
B
Muslu
Muhammet
M
Gözdemir
Benan
B
Kasapoglu
Hüseyin
H
Sert
Rüveyda Irem
RI
Demircioğlu
Safinaz
S
Karabayirli
D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D015760:Alfentanil; D008874:Midazolam; D005283:Fentanyl