Details

Autor(en) / Beteiligte

• Hong, Mi Jin
• Sung, In-Kyung
• Lee, Sang Pyo
• Cheon, Bo-Kyung
• Kang, Hyun
• Kim, Tae-Yop

Titel

Randomized comparison of recovery time after use of remifentanil alone versus midazolam and meperidine for colonoscopy anesthesia

Ist Teil von

• Digestive endoscopy, 2015-01, Vol.27 (1), p.113-120

Ort / Verlag

Australia: Blackwell Publishing Ltd

Erscheinungsjahr

2015

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background and Aim Although the combination of midazolam‐meperidine has been widely used as a sedation regimen for colonoscopy, its residual effect which is longer than the duration of a colonoscopy procedure can delay patient recovery and discharge. Remifentanil, an ultra‐short‐acting opioid, has a very brief duration of action. We hypothesized that using remifentanil alone for colonoscopy would provide shorter recovery time compared with the midazolam‐meperidine combination. Methods Time to achieve Aldrete score = 10 was determined and compared in patients who were randomly allocated to receive remifentanil alone (group‐R, n = 27) or a midazolam‐meperidine combination (group‐MM, n = 27) for colonoscopy. Intergroup differences in sedation, recall analgesia, cardio‐respiratory profiles, and satisfaction of patient and endoscopist were also determined during and after colonoscopy. Results Group‐R showed a significantly shorter recovery time than group‐MM (median [25–75%], 0 [0–10] vs 30 [15–30] min, P < 0.001). Group‐R showed significantly higher bispectral‐index values during colonoscopy (92 [85–96] vs 84 [80–87], P = 0.001); a higher incidence of recall of explanations given during and after colonoscopy (100 vs 48% and 96 vs 52%, both P < 0.001); and a lower distress score (visual analog scale 30/100 vs 37/100 mm, P = 0.002), than did group‐MM. Neither extent of pain, incidence of hemodynamic instability nor incidence of respiratory depression differed between the groups. Conclusions Remifentanil for colonoscopy afforded faster recovery compared to midazolam‐meperidine combination. It also provided greater patient–endoscopist communication and satisfaction with comparable patient analgesia and cardiorespiratory profile during colonoscopy.