Sedation for Colonoscopy Procedures Using Dexmedetomidine Versus Propofol-Fentanyl Infusions: A Prospective Randomized Controlled Trial.

Sameh Hamdy Seyam, Mohamed Abdelgawad Abdelhalim Aboelsuod, Ismail Mohamed Abdelgawad Ahmed, Abdallah Elabd Hassan
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Abstract

Objective: Different anaesthetists for sedation or monitored anaesthesia care have been used for colonoscopy. The target of this research was the ability to perform colonoscopy under a painless degree of sedation and the prevalence of undesired proceedings.

Methods: A total of 60 patients were randomly divided into two groups: Group D received dexmedetomidine and Group PF received propofol-fentanyl. Patients in both groups received the same infusion ratio. The minimum infusion amount of dexmetatomidine is (0.1 to 0.4 μg kg-1 h-1) in Group D, whereas fentanyl is administered at a rate of 0.01 to 0.05 μg kg-1 min-1 in the PF group during the approximately 45-min colonoscopy.

Results: Group D exhibited significantly lower modified Observer's Assessment of Alertness/Sedation (OAA/S) scores at intraoperative time points T1-T12. Group D also exhibited significantly lower visual analog scale scores for pain at intraoperative time points T4 and T7. The mean arterial pressure was significantly lower in Group D at intraoperative times T6-T8 and T11-T12, as well as upon admission to the post-anaesthesia care unit (PACU) and 30 min after admission to the PACU. The results of the ANOVA tests revealed a significantly lower heart rate in Group D. The respiratory rate exhibited a notable decrease during time intervals T8 and T10 in the PF group.

Conclusion: The administration of dexmetatomidine and propofol-fentanyl during colonoscopy was found to be safe. In addition, dexmetatomidine may present significant benefits in this context because of its lower occurrence of adverse respiratory events.

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使用右美托咪定与丙泊酚-芬太尼输注进行结肠镜检查手术镇静:前瞻性随机对照试验。
目的:结肠镜检查中使用了不同的麻醉师进行镇静或监测麻醉护理。本研究的目标是在无痛镇静状态下进行结肠镜检查的能力以及不良反应的发生率:共有 60 名患者被随机分为两组:D组接受右美托咪定,PF组接受丙泊酚-芬太尼。两组患者的输注比例相同。在大约 45 分钟的结肠镜检查过程中,D 组的右美托咪定最低输注量为(0.1 至 0.4 μg kg-1 h-1),而 PF 组的芬太尼输注量为 0.01 至 0.05 μg kg-1 min-1:结果:D组在术中T1-T12时间点的改良观察者警觉/镇静评估(OAA/S)评分明显较低。D 组在术中时间点 T4 和 T7 的疼痛视觉模拟量表评分也明显较低。在术中时间点 T6-T8、T11-T12,以及进入麻醉后护理病房(PACU)时和进入 PACU 后 30 分钟,D 组的平均动脉压明显较低。方差分析的结果显示,D组的心率明显降低,PF组的呼吸频率在T8和T10时间段明显下降:结论:结肠镜检查期间使用右美托咪定和丙泊酚-芬太尼是安全的。此外,由于右美托咪定发生呼吸系统不良事件的几率较低,因此在结肠镜检查中使用右美托咪定可能具有显著的优势。
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