Patient-controlled Analgesia and Sedation With Alfentanyl Versus Fentanyl for Colonoscopy: A Randomized Double Blind Study

• Published in: Journal of clinical gastroenterology Vol. 45; no. 7; pp. e72 - e75
• Main Authors: Usta, Burhanettin, Türkay, Cansel, Muslu, Bünyamin, Gözdemir, Muhammet, Kasapoglu, Benan, Sert, Hüseyin, Demircioğlu, Rüveyda Irem, Karabayirli, Safinaz
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-08-2011
• Subjects: Adult; Aged; Alfentanil - administration & dosage; Analgesia, Patient-Controlled - methods; Analgesics, Opioid - administration & dosage; Anesthetics, Intravenous - administration & dosage; Colonoscopy; Conscious Sedation - methods; Double-Blind Method; Female; Fentanyl - administration & dosage; Humans; Male; Midazolam - administration & dosage; Middle Aged; Patient Satisfaction; Treatment Outcome
• ISSN: 0192-0790; 1539-2031
• DOI: 10.1097/MCG.0b013e318201fbce

STUDY OBJECTIVEThe 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.
PATIENTSOne hundred American Society of Anesthesiology physical status I and II adult patients.
INTERVENTIONSPatients were randomized in a double-blind trial to receive either alfentanyl (n=50) or fentanyl (n=50) by PCA, and incremental doses of midazolam.
MEASUREMENTSPatient 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.
RESULTAll 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.
CONCLUSIONSPCA 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.