Comparison of Fentanyl versus Meperidine in Combination with Midazolam for Sedative Colonoscopy in Korea
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background/Aims: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy. Methods: A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as theprimary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes. Results: A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantlymore rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min,p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001),but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal timeand adenoma detection rate between the two groups. Conclusions: The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.
Abstract
Background/Aims: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy. Methods: A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as theprimary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes. Results: A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantlymore rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min,p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001),but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal timeand adenoma detection rate between the two groups. Conclusions: The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.
참고문헌 (16)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016", Cancer Research and Treatment, 51(2), pp.417~430 (2019), 대한암학회
- 통계청 인구동향과, "Cause-of-death statistics in 2016 in the Republic of Korea", 대한의사협회지, 61(9), pp.573~584 (2018), 대한의사협회[DOI]
- Pan J, "Colonoscopy reduces colorectal cancer incidence and mortality in patients with non-malignant findings : a meta-analysis", Am J Gastroenterol, 111, pp.355~365 (2016)
- Obara K, "Guidelines for sedation in gastroenterological endoscopy", Dig Endosc, 27, pp.435~449 (2015)
- Triantafillidis JK, "Sedation in gastrointestinal endoscopy : current issues", World J Gastroenterol, 19, pp.463~481 (2013)
- 이태훈, "Endoscopic Sedation: From Training to Performance", Clinical Endoscopy, 47(2), pp.141~150 (2014), 대한소화기내시경학회
- 문성훈, "Sedation Regimens for Gastrointestinal Endoscopy", Clinical Endoscopy, 47(2), pp.135~140 (2014), 대한소화기내시경학회
- Cohen LB, "AGA institute review of endoscopic sedation", Gastroenterology, 133, pp.675~701 (2007)
- Horn E, "Pharmacology and pharmacokinetics of sedatives and analgesics", Gastrointest Endosc Clin N Am, 14, pp.247~268 (2004)
- Childers RE, "Practice patterns of sedation for colonoscopy", Gastrointest Endosc, 82, pp.503~511 (2015)
- Phillips SN, "Parenteral opioid analgesia : does it still have a role?", Best Pract Res Clin Anaesthesiol, 31, pp.3~14 (2017)
- Hinkelbein J, "European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults", Eur J Anaesthesiol, 35, pp.6~24 (2018)
- Aldrete JA, "The post-anesthesia recovery score revisited", J Clin Anesth, 7, pp.89~91 (1995)
- Jin EH, "How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?", World J Gastroenterol, 23, pp.1098~1105 (2017)
- Hayee B, "Midazolam with meperidine or fentanyl for colonoscopy : results of a randomized trial", Gastrointest Endosc, 69(3 Pt 2), pp.681~687 (2009)
- Tegeder I, "Pharmacokinetics of opioids in liver disease", Clin Pharmacokinet, 37, pp.17~40 (1999)