Humayra Garda, Shezaad Javid, Osama Elfaedy, Frederick Pretorius, Paul Balfe, Sayed Alam
Background: Colonoscopy is an important and frequently used investigation in the diagnosis of colorectal cancer. Various methods of sedation are used when performing colonoscopy, and these vary depending on the centre or country where the investigation is performed. Propofol, fentanyl, pethidine and midazolam and some of the more frequently used drugs for sedation and analgesia in colonoscopy in different combinations. Both fentanyl and pethidine are used routinely in combination with midazolam for sedation in colonoscopy in many centres in Ireland and are both found to be safe and effective as found in previous studies. However comparison of the effectiveness of each drug with regards to patient experience, safety, recovery time and overall outcome during colonoscopy has not been well established. The primary objective in this study is to compare if there is any significant difference between pethidine and fentanyl used in combination with midazolam as sedation in colonoscopy.
Methods: This is a retrospective comparative study done at St. Luke’s Hospital, Kilkenny, looking at data stored about already used common practise sedation methods in colonoscopy. Parameters used were patient’s sex, age, procedure length, sedation drugs and doses used, recovery time and comfort score were all compared to reach a conclusion. Patients who had colonoscopy from July 2016 to June 2017 were included in this study.
Results: A total of 296 patient’s data were analyzed. Both groups of patients received midazolam mean dosage of 4.5 mg (range, 2–8 mg). The 148 patients received fentanyl mean dose 75 mg (range, 25–100 mg) achieved better comfort scores than the 148 patients who received pethidine mean dose of 30mg (range, 25–50 mg). Patients who received pethidine achieved an average comfort score of 2 compared to the patients on fentanyl who achieved a comfort score of 1.
Conclusions: Fentanyl combined with midazolam achieved a better average comfort score than pethidine with midazolam.
