title: Sedation, analgesia, and cardiorespiratory function in colonoscopy using midazolam combined with fentanyl or propofol.
abstract: OBJECTIVE
  The use of sedatives during colonoscopy remains controversial because of its safety concerns. We compared cardiorespiratory function and sedative and analgesic effects in sedative colonoscopy, using combinations of midazolam with either fentanyl or propofol.
  
  
  METHODS
  Eligible patients (n = 480) received 1.0-2.0 mg midazolam alone (n = 160), midazolam combined with either 50-100 mg fentanyl intramuscularly (n = 160), or 0.5-2.5 mg/kg propofol intravenously, as premedication for sedative colonoscopy. Pulse rate, blood pressure, and saturation of peripheral oxygen (SpO(2)) were monitored. Levels of sedation and analgesia were semi-quantitatively scored using visual analog scales, and amnesia profiles were qualitatively evaluated.
  
  
  RESULTS
  Combining midazolam with either fentanyl or propofol resulted in acceptable sedative and analgesic effects compared to treatment with midazolam alone (P < 0.001), with the combination with propofol giving more favorable results. More patients receiving the propofol combination became amnestic to the procedure than patients receiving the fentanyl combination. However, midazolam combined with propofol disturbed the pulse rate (P < 0.05) and blood pressure (P < 0.001) more significantly than a combination with fentanyl, or midazolam alone.
  
  
  CONCLUSIONS
  The combination of midazolam with either fentanyl or propofol allowed patients to undergo colonoscopy under comparable sedative and analgesic conditions. The combination with fentanyl had a significantly lower effect on pulse rate and blood pressure. The combination with propofol produced superior amnestic effects.
authors.affiliation: Department of Gastroenterology, the Third Xiangya Hospital of Central South University, 183 Tongzipo Street, Changsha 410013, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Wang
authors.forename: Shou-Rong
authors.initials: SR
authors.lastname: Shen
authors.forename: Ding-Hua
authors.initials: DH
authors.lastname: Xiao
authors.forename: Can-Xia
authors.initials: CX
authors.lastname: Xu
authors.forename: Wu-Liang
authors.initials: WL
authors.lastname: Tang
mesh_terms: D000647:Amnesia / Q000139:chemically induced; D000698:Analgesia; D001794:Blood Pressure; D003113:Colonoscopy / Q000379:methods*; D003710:Demography; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006334:Heart Function Tests; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010100:Oxygen; D010313:Partial Pressure; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D012129:Respiratory Function Tests
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D010100:Oxygen; D005283:Fentanyl; D015742:Propofol