Although colonoscopy is a mildly painful procedure, the pain and the procedure itself are distressful for most patients. This raises the attention for using different sedation regimens aiming at maintaining optimal sedation level with maintained airway and stable haemodynamics all through the procedure. The present study was scheduled to investigate the sedative efficacy of dexmedetomedine versus propofol-remifentanil for outpatient colonoscopy.
Eighty patients undergoing outpatient colonoscopy will be randomized into two equal groups. In Dexmedetomidine (DEX) group the patients will be administered a loading dose of i.v. dexmedetomidine 1 μg/kg over 10 min, followed by a continuous infusion of 0.2-1 μg/kg/h, titrated according to the sedation score, till the end of the procedure. In the PR group, propofol will be started by a loading dose of 0.5 mg/kg over 3-5 minutes then a maintenance infusion of 25-75 μg kg/min. Remifentanil infusion will be started at 1 μg kg over one minute then and 0.01-0.1 μg kg/min. If the patient complained of pain or discomfort, the infusion rates of dexmedetomidine (DEX group) or propofol-remifentanil (P-R group) will be increased. If the higher limit of the dose range of the study drugs reached, additional fentanyl 0.5 μg/kg i.v. boluses will be administered. Rescue medication consisting of propofol boluses of 0.5 mg/kg i.v. will be given if the previous protocol failed. Sedation score,haemodynamics, end-tidal carbon dioxide, oxygen saturation, total fentanyl, propofol bolus doses, patient and colonoscopist satisfaction and side effects will be recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
80
dexmedetomidine sedation
propofol sedation
Remifentanil sedation
Faculty of Medicine
Cairo, Shebin El-kom, Egypt
Sedation
Degree of sedation by Ramsay sedation score from 1 inadequate sedation to 6 excessive sedation.
Time frame: Perioperative
Mean arterial blood pressure
Mean arterial blood pressure in mmHg
Time frame: Perioperative
Heart rate
Heart rate in beats/minutes
Time frame: Perioperative
Oxygen saturation
Arterial oxygen saturation as a percentage of the total haemoglobin.
Time frame: Perioperative
Hypotension
Number of patients with hypotension
Time frame: Perioperative
Bradycardia
Number of patients with bradycardia
Time frame: Perioperative
Analgesia
Measured by visual analogue scale \[from 0 "no pain" to 10 "worst imaginable pain"\]
Time frame: Perioperative
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