Conscious analgesia/sedation with remifentanil and propofol versus total intravenous anesthesia with fentanyl, midazolam, and propofol for outpatient colonoscopy

Rudner, Robert; Jałowiecki, Przemysław; Kawecki, Piotr; Gonciarz, Maciej; Mularczyk, Aldona; Petelenz, Michał

doi:10.1067/mge.2003.207

Cited by 98 publications

(78 citation statements)

References 19 publications

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“…(11) Rudner ve ark. (12) 'da sedasyon amacıyla remifentanil ile propofolü birlikte uyguladıkları kolonoskopi hastalarında, derlenme odasına transfer süresini 2,9 dk. olarak bulmuş-tur.…”

Section: Discussionunclassified

Intermittent Bolus vs Target Controlled Infusion of Propofol Sedation for Colonoscopy

Dal¹,

İzdeş²,

Kesimci³

et al. 2011

J Turk Anaesth Int Care

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ÖZETAmaç: Elektif kolonoskopilerde, sedasyon için propofolün hedef kontrollü infüzyon veya aralıklı bolus uygulanmasının propofol tüketimi, hemodinami, işlem sırasında hasta konforu ve derlenme üzerine etkilerini karşılaştırmayı amaçladık.Gereç ve Yöntem: Çalışmaya etik kurul onayı alınan, ASA I-II, 18-65 yaş arası, 66 hasta alındı. Hastalara remifentanil 0,05 μg kg dk -1 iv başlandıktan 2 dk. sonra, propofolün hedef kontrollü infüzyonla (Grup HKİ) veya aralıklı bolus (Grup B) verilmesine göre gelişigüzel yöntemle 2 eşit gruba ayrıldı. Propofol iv yoldan; Grup HKİ'de etki yeri hedef konsantrasyonu 2 µg mL -1 , Grup B'de bolus 0,5 mg kg -1 dozda uygulandı. Ramsey Sedasyon Skalası 3-4'e ulaşana kadar Grup HKİ'de konsantrasyon 0,5 µg mL -1 artırılıp, Grup B'de 0,25 mg kg -1 propofol iv uygulandı. Hemodinami ve solunumsal parametreler, propofol tüketimi, işlemi hatırlama, rüya görme, ağrı, hasta memnuniyeti, göz açma ve derlenme zamanı kaydedildi.Bulgular: Grup HKİ'de kalp atım hızı, işlemin 1. ve 2. dk.'da (p<0,05-p<0,01); Grup B'de işlemin 5. dk.'sı hariç tüm ölçüm zamanlarda kontrol değerlerine göre anlamlı yüksekti (p<0.01). Ortalama arter basıncı işlemin 5., 6., 7. ve 8. dk.'larında Grup B'de, Grup HKİ'ye göre anlamlı yüksekti (p<0,05-p<0,01). İşlemi hatırlama, rüya görme, işlem sırasında ağrı duyma, hasta memnuniyeti, toplam propofol dozu, göz açma ve derlenme zamanı bakımından gruplar arasında anlamlı bir fark saptanmadı.Sonuç: Kolonoskopilerde sedasyon amacıyla hedef kontrollü infüzyon ile uygulanan propofolün, aralıklı bolus uygulamaya göre, ilaç tüketimi ve derlenme açısından belirgin bir üstünlük sağlamamasına karşın, işleme hemodinamik yanıtı daha iyi önlediği için seçilebileceğini düşünmekteyiz.Anahtar kelimeler: Sedasyon, anestezik, intravenöz, propofol, infüzyon; hedef kontrollü SUMMARY Intermittent Bolus vs Target Controlled Infusion of Propofol Sedation for ColonoscopyObjective: We aimed to compare the effects of propofol via target controlled infusion (TCI) or intermittent bolus (B) method on propofol consumption, hemodynamics, patient's comfort and recovery in colonoscopies.Materials and Methods: Following Ethical Committee's approval, 66 patients, (ASA I-II, 18-65 yrs) were allocated to one of two groups receiving propofol administered a either TCI or intermittent bolus (B) supplemented with remifentanil (0,05 µg kg min -1 iv). After 2 minutes, iv propofol was titrated as 0,5 µg mL -1 effect-site concentration and as 0,25 mg kg -1 bolus increments to achieve Ramsey Sedation Score of 3-4 in Groups TCI and B, respectively. Hemodynamic and respiratory parameters, total propofol requirements, the incidence of recall and dreaming, pain intensity, patient satisfaction, time to opening eyes, and also to recovery were recorded.Results: Heart rate increased significantly at first 1.-2. min in Group TCI (p<0,01), and measurements at all time-points except at 5 min in Group B (p<0,01) compared with baseline. Mean arterial pressure was significantly higher in Group B at 5., 6., 7. and 8. min than the corresp...

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Section: Discussionunclassified

Intermittent Bolus vs Target Controlled Infusion of Propofol Sedation for Colonoscopy

Dal¹,

İzdeş²,

Kesimci³

et al. 2011

J Turk Anaesth Int Care

View full text Add to dashboard Cite

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“…The reduction of mean arterial pressure, heart rate, respiratory rate, oxygen saturation and endexpiratory carbon dioxide in the TIVA group was significantly greater than in the remifentanil infusion and propofol bolus group. Furthermore, no serious adverse events were observed in both groups [7] . They also tested the hypothesis that sedation with remifentanil and propofol might be more effective compared with anesthesia by intravenous administration of midazolam, fentanyl and propofol in colonoscopy.…”

Section: Single Bolus Administrationmentioning

confidence: 97%

Intravenous Sedation Techniques for Gastrointestinal Endoscopy

Amornyotin

2016

Journal of Gastroenterology and Hepatology Research

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Gastrointestinal endoscopic (GIE) procedure has become an essential modality for evaluation and management of gastrointestinal tract abnormalities. The safe sedation of patients for this procedure requires a combination of properly trained physicians and appropriate facilities. Moreover, proper selection and preparation of patients, suitable sedative technique, and application of drugs is essential. Irrespective of regimen used, the safe administration of sedative drugs requires an awareness of the individual needs of the patients. To date, the most commonly used sedation technique for GIE procedure is intravenous technique. The use of short acting drug, adequate dose of sedative agents and sedation endpoint as well as appropriate sedation technique has an important role and also increased the safety. Several intravenous sedation techniques are presently used and evaluated. This article reviews and discusses the current status of the intravenous techniques for sedation in various GIE procedures.

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“…The synergistic effect of midazolam and propofol is more apparent and has proven to be safe and effective. Several reports have favored the use of propofol for sedation during gastrointestinal endoscopy (GIE) procedures [3,[6][7][8][9] . However, propofol also has some disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…Benzodiazepines and propofol in various combinations are administered to the patients to provide sedation [1,[6][7][8] . The synergistic effect of midazolam and propofol is more apparent and has proven to be safe and effective.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Combination of Propofol and Ketamine(Ketofol) for Deep Sedation in Colonoscopic Procedure

Amornyotin

Kongphlay

2015

Journal of Gastroenterology and Hepatology Research

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AIM:To compare and evaluate the clinical efficacy of the combination of propofol and ketamine (ketofol) versus propofol alone when each regimen is used as sedative agents for colonoscopy. METHODS: 100 patients who underwent colonoscopy in two years, were randomly assigned to PN and PK groups. 50 patients in group PN received propofol and normal saline and 50 patients in group PK received propofol and ketamine for deep sedation. All patients were premedicated with 0.02-0.03 mg/kg of midazolam. Immediately after the procedure, the endoscopist was asked to rate tolerability for the patient, discomfort during insertion and satisfaction. As well, a blinded member of the research team evaluated the patient satisfaction, procedural pain, recovery time and recovery score. The primary outcome was the successfully completed colonoscopic procedure. The secondary outcome variables were patient tolerance, discomfort during insertion, patient and endoscopist satisfaction, recovery time and recovery score, hemodynamic parameters, as well as adverse events during and immediately after procedure. RESULTS: All endoscopies were completely successfully. Mean total dose of midazolam in group PK and PN was 0.027±0.005 mg/kg and 0.026±0.005 mg/kg, respectively (p=0.469). Mean total dose of propofol in group PK and PN was 7.28±3.03 mg/kg/ h and 8.02±2.99 mg/kg/h, respectively (p=0.451). Mean total dose of ketamine in group PK was 1.49±0.61 mg/kg/h. There were no significant differences in the patient and endoscopist satisfaction, procedural pain and recovery time, but the recovery score at 30 min post-procedure in group PK was significantly lower than group PN (p=0.025). Tolerability of the patient and comfort during insertion in group PN were statistically significantly lower than the patients in group PK. Overall and sedation-related adverse event rate in group PN were also significantly higher than in group PK. However, these adverse events were transient and easily treated with no sequelae. CONCLUSION: Deep sedation in both regimens provided effective and safe for colonoscopy. No serious adverse events were observed. However, the combination of propofol and ketamine (ketofol) used as sedative agents for deep sedation had significantly higher efficacy than the propofol alone.

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Conscious analgesia/sedation with remifentanil and propofol versus total intravenous anesthesia with fentanyl, midazolam, and propofol for outpatient colonoscopy

Cited by 98 publications

References 19 publications

Intermittent Bolus vs Target Controlled Infusion of Propofol Sedation for Colonoscopy

Intermittent Bolus vs Target Controlled Infusion of Propofol Sedation for Colonoscopy

Intravenous Sedation Techniques for Gastrointestinal Endoscopy

Clinical Efficacy of Combination of Propofol and Ketamine(Ketofol) for Deep Sedation in Colonoscopic Procedure

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