There are different sedation regimes for lower gastrointestinal system endoscopy which can be administered by anesthesiologists and non-anesthesiologists. This study aims to compare the effects of propofol/remifentanil combination and midazolam/meperidine combination on early cognitive function following lower gastrointestinal system endoscopies.
Sedation for lower gastrointestinal system endoscopies can be administered by anesthesiologists or endoscopists and cognitive dysfunction after this procedure has not been fully investigated. The aim of this study was to investigate the effect of different sedation regimes applied by anesthesiologists or endoscopists on early cognitive dysfunction. Following ethics committee approval and written informed consent, 100 patients were randomly divided into two groups. In Group MM where drug regime was solely determined by endoscopists, 2 mg midazolam and 20mg meperidine was given intravenously and additional 1-2mg midazolam and 20mg meperidine (wtih a maximum total of 5 mg midazolam and 50 mg meperidine) was given when facial pain scale (FPS) was greater than 3. In Group RP where drug regime was solely determined by anesthesiologists, 100 mcg/kg/min propofol infusion and 1 mcg/kg remifentanil bolus was administered and additional 0,5 mcg/kg remifentanil bolus was given when FPS was greater than 3. Bispectral index (BIS) and hemodynamic monitorization was carried out throughout the procedure and BIS 60-80 with FPS\<3 was targeted. The time to Observer Assessment of Alertness/Sedation Scale (OAAS) score to reach 3 was measured after the procedure and Trieger Dot Test (TDT) and Digit Symbol Substitution Test (DSST) was repeated at 5th, 15th and 30th minutes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
103
Change in Cognitive Function
As measured by Trieger Dot Test. The test does not have an upper limit; the time taken to complete the test is added to the number of dots missed by the patient and a result is obtained. The lowest score possible is 0. Higher values represent worse outcomes.
Time frame: Baseline and 5, 15, 30 minutes after the procedure
Change in Cognitive Function
As measured by Digit Symbol Substitution Test. Scale range 0-9. No cut-off value. Higher results represent better outcomes
Time frame: Baseline and 5, 15, 30 minutes after the procedure
Change in Visual Analogue Scale Scores From the Baseline
Pain as measured by Visual Analogue Scale. Range 1-10. No cut-off value, Higher results represent worse outcomes
Time frame: Baseline and 5, 15, 30 minutes after the procedure
Heart Rate
Heart rate as measured in beats per minute
Time frame: Baseline and 1,2,3,5,10,15 and 20 minutes
Mean Arterial Pressure
mean arterial blood pressure as measured in mmHg
Time frame: Baseline and 1,2,3,5,10,15 and 20 minutes
Peripheral Oxygen Saturation
peripheral oxygen saturation as measured by pulse oximeter. Units are percentages, Scale range 0-100.
Time frame: Baseline and 1,2,3,5,10,15 and 20 minutes
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Dosage adjustment