Sedo-analgesia para colonoscopía. Comparación entre midazolam + fentanil versus propofol + fentanil. Hospital Vicente Corral Moscoso y Hospital José Carrasco Arteaga, Cuenca 2014

Abstract

Introduction. Colonoscopy is the endoscopic examination of the large intestine, a procedure that is usually performed on an outpatient basis and it is unpleasant and painful. Commonly, is performed with general anesthesia or with sedatives or over-the-counter pain relievers which separately do not guarantee benefit for the patient. Objective. Compare the sedative and analgesic effect of midazolam/fentanyl versus propofol/fentanyl in colonoscopy. Methodology. Controlled clinical trial randomized single-blind study that included 216 patients randomly assigned to two equal groups. Group A (n = 108) received midazolam plus fentanyl and group B (n = 108) propofol more fentanyl. Assessed the degree of sedation with the scale of Ramsay and the pain through indirect parameters such as blood pressure and heart rate. Other parameters assessed were the saturation of oxygen. Averages were compared using analysis of variance, was considered to be statistically significant values of p<0.05. Results: The degree of sedation valued by the scale of Ramsay-Hunt , demonstrated statistically significant differences in the 5 minutes, not as well, 15, 30 and 45 minutes. The biggest differences between the two groups are for grade IV sedation was obtained after 5 minutes in 2 patients in group A, unlike the group B, where 18 patients had a higher level of the desired sedation (Ramsay 2 or 3). No significant differences were observed in the values of the arterial blood pressure, heart rate, oxygen saturation and respiratory rate, p-values>0.05 . Conclusions: With the use of midazolam are fewer cases of deep sedation, without which there are significant differences in cardiovascular and respiratory parameters among the groups studied