Document Detail


Patient-controlled sedation versus intravenous sedation for colonoscopy in elderly patients: a prospective randomized controlled trial.
MedLine Citation:
PMID:  12397267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A prospective randomized trial was conducted to compare the safety, effectiveness, and patient acceptance of patient-controlled sedation and intravenous sedation for colonoscopy in a group of elderly patients undergoing outpatient colonoscopy. METHODS: One hundred patients over 65 years of age were recruited and randomized to patient-controlled sedation (n = 50) or intravenous sedation (n = 50) groups by means of computer-generated numbers. In the patient-controlled sedation group, a mixture of propofol and alfentanil was delivered by means of a patient-controlled pump; each bolus delivered 4.8 mg propofol and 12 microg alfentanil. No loading dose was used and the lockout time was set at zero. In the intravenous sedation group, fixed doses of diazemuls (0.1 mg/kg) and meperidine (0.5 mg/kg) were given with further increases in dosages administered at the discretion of the endoscopist. Outcome measures assessed included cardiopulmonary complications, recovery time, pain score, and satisfaction score. RESULTS: The mean (SD) age of patients in the patient-controlled sedation and intravenous sedation groups were, respectively, 72.4 years (5.3) and 73.5 years (6.1). The mean dose of propofol consumed in the patient-controlled sedation group was 0.79 (0.46) mg/kg. The mean doses of diazemuls and meperidine consumed in intravenous sedation group were, respectively, 5.8 (1.3) mg and 30.1 (6.8) mg. Hypotension occurred in 2 (4%) patients in the patient-controlled sedation group and 14 (28%) in the intravenous sedation group (p < 0.01). Oxygen desaturation was recorded for 4 patients (8%) in the intravenous sedation group. The median (interquartile range [IQR]) recovery time was significantly shorter in the patient-controlled sedation group compared with the intravenous sedation group (respectively, 0 minutes [IQR 0-5] vs. 5 minutes [IQR 5-10]; p < 0.01). There were no statistically significant differences between groups for pain and satisfaction scores. CONCLUSIONS: Patient-controlled sedation appears to be safer than intravenous sedation, with comparable effectiveness and acceptance, in elderly patients undergoing elective outpatient colonoscopy.
Authors:
Danny W H Lee; Angus C W Chan; Tak-Suen Sze; Chi-Wah Ko; Chi-Ming Poon; Kang-Chung Chan; Kwok-Sang Sin; S C Sydney Chung
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  56     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-24     Completed Date:  2003-04-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  629-32     Citation Subset:  IM    
Affiliation:
Department of Surgery, North District Hospital, New Territories East Cluster, Hong Kong SAR, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Alfentanil / administration & dosage*,  adverse effects
Analgesia, Patient-Controlled* / adverse effects
Anesthetics, Intravenous / administration & dosage*,  adverse effects
Colonoscopy
Conscious Sedation / methods*
Diazepam / administration & dosage,  adverse effects
Female
Gastrointestinal Diseases / diagnosis
Humans
Hypnotics and Sedatives / administration & dosage,  adverse effects
Hypotension / etiology
Male
Meperidine / administration & dosage,  adverse effects
Pain Measurement
Patient Satisfaction
Propofol / administration & dosage*,  adverse effects
Prospective Studies
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Hypnotics and Sedatives; 2078-54-8/Propofol; 439-14-5/Diazepam; 57-42-1/Meperidine; 71195-58-9/Alfentanil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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