title: Sedation-analgesia in elective colonoscopy: propofol-fentanyl versus propofol-alfentanil.
abstract: OBJECTIVE
  Sedation-analgesia is recommended for comfortable colonoscopy procedures, which are invasive and can be painful. This study aimed to compare the combinations of propofol-alfentanil and propofol-fentanyl for sedation-analgesia in elective colonoscopy patients.
  
  
  METHODS
  This prospective and randomized study was planned in ASA I-II groups and included 80 patients between the ages of 18 and 65 years. Sedation-analgesia induction was performed as 1 μg.kg(-1) fentanyl, 1mg.kg(-1) propofol in the propofol-fentanyl group (Group PF) and 10 μg.kg(-1) alfentanil, 1mg.kg(-1) propofol in the propofol-alfentanil group (Group PA). Patients' scores were limited to 3-4 values on the Ramsey Sedation Scale (RSS) by 0.5mg.kg(-1) bolus additional doses of propofol in sedation-analgesia maintenance. We recorded demographical data, heart rate, mean arterial pressure (MAP), oxygen saturation of hemoglobin (SpO2), RSS value, colonoscopy time, total dose of propofol, complications, recovery time, and discharge time, as well as colonoscopist and patient satisfaction scores.
  
  
  RESULTS
  MAP at the 15(th) minute in Group PA was significantly higher than in Group PF (p = 0.037). Group PA's beginning mean heart rate was higher than the mean heart rate at subsequent readings (p = 0.012, p = 0.002). The mean total propofol dose of Group PA was significantly higher than the total dose of Group PF (p = 0.028). The mean recovery time of Group PA was significantly longer than that of Group PF (p = 0.032).
  
  
  CONCLUSIONS
  Fentanyl provides better operative conditions and reduces the need for additional propofol doses. These advantages cause a shorter recovery time. Therefore, propofol-fentanyl is superior to the propofol-alfentanil for sedation-analgesia in colonoscopy.
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey. Electronic address: hacersebnem@yahoo.com.tr.
authors.forename: Hacer Şebnem
authors.initials: HŞ
authors.lastname: Türk
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Aydoğmuş
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Unsal
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey; Şişli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
authors.forename: Hakan Mustafa
authors.initials: HM
authors.lastname: Köksal
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey.
authors.forename: Mehmet Eren
authors.initials: ME
authors.lastname: Açik
authors.affiliation: Şişli Etfal Training and Research Hospital, Department of Anesthesiology and Intensive Care Medicine, Istanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Oba
mesh_terms: D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D003113:Colonoscopy; D004338:Drug Combinations; D017558:Elective Surgical Procedures; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D005283:Fentanyl; D015742:Propofol
keywords: Alfentanil; Colonoscopy; Fentanyl; Propofol