Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Oct 2018)
Comparison of the Sedative Effect and Recovery Time of Dexmedetomidine and Fentanyl during Elective Colonoscopy
Abstract
BACKGROUND AND OBJECTIVE: Various medications such as propofol or midazolam are used with or without fentanyl as sedatives for colonoscopy. Dextroduromedine is a new sedative that activates the alpha-2 adrenergic receptor in the brain and the spinal cord with sedative, analgesic and sympatholytic effects. The aim of this study was to compare the sedative effect and recovery time of dexmedetomidine and fentanyl during elective colonoscopy. METHODS: In this double – blind clinical trial, 80 colonoscopy candidates aged 20-70 years old were randomly divided into two equal groups. 1 mcg/kg dexmedetomidine was administered to the intervention group and 0.5 mcg / kg fentanyl was administered to the control group before the start of the colonoscopy. Propofol (20 mg) was administered as bolus dose if needed during colonoscopy. The sedation rate was recorded based on Ramsay standard and mean bolus dose of propofol during colonoscopy. Recovery time and pain were recorded based on Visual Analog Scale (VAS) before discharge. FINDINGS: The two groups did not have a significant difference in terms of age, gender and sedation rate. The mean bolus dose of propofol in the fentanyl group was 72±14 and in the dexmedetomidine group was 7±0.24 mg (p=0.000). The recovery time in the fentanyl group was 4.38±2.38 minutes and in the dexmedetomidine group was 2.63±1.22 minutes (p=0.000). The pain after colonoscopy was 2.30±0.69 in the fentanyl group and 1.98±0.7 in the dexmedetomidine group (p=0.039). CONCLUSION: The results of this study showed that the combination of dexmedetomidine and propofol are more suitable for colonoscopy compared to the combination of fentanyl and propofol due to shorter recovery time.
