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Year : 2019  |  Volume : 16  |  Issue : 1  |  Page : 1-6

A comparison of propofol - fentanyl with midazolam – pentazocine combination for sedation and analgesia during colonoscopy in Ibadan Nigeria

1 Department of Anaesthesia, University College Hospital, Ibadan, Nigeria
2 Department of Medicine, University College Hospital, Ibadan, Nigeria
3 Department of Surgery, University College Hospital, Ibadan, Nigeria

Correspondence Address:
Dr. Tinuola Abiodun Adigun
Department of Anaesthesia, College of Medicine, University of Ibadan and University College Hospital, Ibadan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcls.jcls_38_18

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Background: Benzodiazepines, narcotics, and propofol in different combinations are administered to provide sedation and analgesia during colonoscopy. The study aimed to compare the efficacy and safety of midazolam-pentazocine with the propofol-fentanyl combination for sedation and analgesia during colonoscopy. Patients and Methods: This prospective randomized, double-blind study was conducted in 62 adults aged 18–82 years scheduled for colonoscopy. Patients were assigned into two groups, Group A (n = 31) received midazolam 2.5–5.0 mg with pentazocine 15–30 mg, whereas Group B (n = 31) received propofol 0.5 mg/kg with fentanyl 0.5ug/kg before the procedure. Efficacy was measured by the depth of sedation using Ramsay sedation score (RSS), pain score, and recovery from sedation, whereas safety was evaluated with heart rate, blood pressure (BP), and oxygen saturation. Results: There was no statistically significant difference between the two groups with respect to demographic and clinical data. The patients in Group B were more sedated with a mean RSS of 4.1 ± 0.79 compared with 2.07 ± 0.74 in Group A (P = 0.001). The mean pain score during the procedure was lower in Group B 3.19 ± 1.9 compared with 4.8 ± 1.9 in Group A (P = 0.001). The recovery time was faster in Group B compared with Group A, 24 versus 46 min, respectively (P = 0.001). The systolic BP at 5 and 10 min was lower in Group B (P = 0.024 and P = 0.001), respectively, as well as the diastolic BP at 5 and 10 min (P = 0.042 and P = 0.04), respectively. Hypotension was observed in six patients in Group B compared to two patients in Group A. There was no difference in the heart rates in both groups. Two patients in both groups had desaturation <90%, and oxygen was administered to maintain the oxygenation. No patient developed apnea that would have warranted endotracheal intubation. Conclusion: Propofol-fentanyl combination provided better sedation, less painful procedure, and shorter recovery time with minimal cardiorespiratory complication.

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