• Maria M Manolaraki, Angeliki Theodoropoulou, Charalampos Stroumpos, Emmanouil Vardas, Pantelis Oustamanolakis, Aliki Gritzali, Gregorios Chlouverakis, and Gregorios A Paspatis.
• Department of Anesthesiology, Benizelion General Hospital, Heraklion-Crete, Greece.
• Dig. Dis. Sci. 2008 Jan 1;53(1):34-40.

PurposeThe objective of our study was to compare the safety and efficacy of remifentanil during colonoscopy with those of the standard combination of midazolam and pethidine.MethodsOne-hundred and sixteen consecutive patients scheduled for colonoscopy were randomly assigned to groups A or B. Patients in group A (n = 56) received intravenous (IV) midazolam and pethidine. Patients in group B (n = 60) received IV remifentanil.ResultsRecovery was faster in group B (0 min) than in group A (56 +/- 11.3 min) (P < 0.001). There was a marked difference between groups B and A with regard to the time of hospital discharge-28.7 +/- 4.3 and 148.9 +/- 34 min, respectively (P < 0.001). Patients in group A rated the procedure as comfortable, as also did those in group B. A combination of midazolam and pethidine had a greater affect on patients' cardiorespiratory characteristics.ConclusionRemifentanil during colonoscopy provides sufficient pain relief with better hemodynamic stability, less respiratory depression, and significantly faster recovery and hospital discharge than moderate sedation with midazolam and pethidine.

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