title: Comparison of the analgesic effect of intravenous paracetamol/midazolam and fentanyl in preparation of patients for colonoscopy: A double blind randomized clinical trial.
abstract: BACKGROUND
  Although some patients can tolerate colonoscopy procedure using fentanyl/ midazolam without any sedation and analgesic requirements but some patients may require additional sedation with benzodiazepines. We performed the present study to compare the effect of paracetamol/midazolam with fentanyl/ midazolam.
  
  
  METHODS
  In a clinical trial, 96 patients aged 18 to 75 years old, who were candidate for elective colonoscopy assigned consecutively into two groups as paracetamol/midazolam and fentanyl/midazolam. The first group received 1 gr paracetamol 45 minutes before colonoscopy and 0.5 mg/kg midazolam 5 minutes before colonoscopy whereas the second group received 04- 0.5-1 mcg/kg fentanyl 3 minutes before colonoscopy and similar dose of midazolam. The two groups were compared in regard to patient intensity, discomfort, acolonoscopist and, patient satisfaction and rescue dose of propofol during colonoscopy and vital signs.
  
  
  RESULTS
  There was no significant difference between the two groups for patient pain score, colonoscopist satisfaction, patient satisfaction and rescue dose of propofol (P=0.817, 0.978, 0.460, and 0.104, respectively). The incidence of apnea was greater in fentanyl group (P=0.045). After adjusting for age and education, there was also no significant difference between the two groups.
  
  
  CONCLUSIONS
  This study indicates that paracetamol can be considered as an alternative drug regimen in preparation of colonoscopy.
authors.affiliation: Department of Internal Medicine, Babol University of Medical Science, Babol, Iran.
authors.forename: Abbasali
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: Department of Intensive Care, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Parviz
authors.initials: P
authors.lastname: Amri
authors.affiliation: Department of Internal Medicine, Babol University of Medical Science, Babol, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Shokri
authors.affiliation: Department of Social Medicine and Health, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Karimollah
authors.initials: K
authors.lastname: Hajian
keywords: Analgesia; Colonoscopy; Fentanyl; Paracetamol