Combination of propofol and nasal sufentanil or intravenous midazolam for colonoscopy: acomparative study.

Abstract

The aim of the study was to compare and evaluate the side effects (SEs) and sedation characteristics of synergistic sedation with doses of 0.25 μg kg-1 or 0.5 μg kg-1 intranasal (IN) sufentanil, and intravenous (IV) midazolam during propofol-based sedation in patients undergoing colonoscopy. This was aprospective, randomized, double-blind study. The patients were randomly allocated into one of 3 groups: group I(n = 33) - sufentanil IN 0.5 μg kg-1; group II (n = 33) - sufentanil IN 0.25 μg kg-1; and group III (n = 33) - IN 0.9% NaCl ( placebo ) and IV 0.04 mg kg-1 midazolam. After 15 minutes, all patients received 0.5 mg kg-1 propofol intravenously. Cardiorespiratory side effects and sedation characteristics were compared. The propofol consumption in group III was significantly higher than in group Iand II (P < 0.001). Spontaneous eye opening time was significantly longer in group III than in group Iand II ( < 0.001). The patients in group III had significantly longer recovery times than patients in group Iand II (P < 0.0001). Hypotension and bradycardia were not encountered during the study. The incidence of hypoxaemia was significantly greater in group III compared to other groups (P < 0.001). Pain control and endoscopist satisfaction was significantly better for group Iand II than for group III (P < 0.001). Synergistic sedation can be achieved safely and effectively by the combination of propofol and IN sufentanil or IV midazolam for colonoscopy. However, IN sufentanil can be considered as areasonable alternative to IV midazolam due to less respiratory depression, and better pain control and endoscopist satisfaction.