Deep Sedation with Propofol and Pethidine Versus Moderate Sedation with Midazolam and Fentanyl in Colonoscopic Procedure

Abstract

AIM: To compare and evaluate the clinical efficacy of the combination of propofol and pethidine (PP) versus midazolam and fentanyl (MF) for moderate sedation in colonoscopic procedure. METHODS: 1032 patients were randomly assigned to group PP (518) and group MF (514). Primary outcome variable was the successfully completed colonoscopy. Secondary outcome variables were patient tolerance, discomfort during insertion, patient and endoscopist satisfaction, procedural pain, recovery time and sedation-related complications during and immediately after procedure. RESULTS: All endoscopies were completely successful except 33 patients in group MF and 11 patients in group PP (p=0.019). Additional propofol dose, procedural pain and recovery time in group MF was significantly higher than in group PP. Tolerability of the patient, comfort during insertion, patient and endoscopist satisfaction and sedation-related complications in group MF were significantly lower than in group PP. No serious complications were observed in both gropus. CONCLUSION: The efficacy of propofol and pethidine for deep sedation shows an advantage over midazolam and fentanyl for moderate sedation used for colonoscopy in term of procedure completion rate, ease of endoscopy, as well as patient’s and endoscopist’s satisfaction. However, the combination of propofol and pethidine for deep sedation produces a higher complication rate than in the combination of midazolam and fentanyl for moderate sedation.