passages: 705
passages: document
passages: Conscious analgesia/sedation with remifentanil and propofol versus total intravenous anesthesia with fentanyl , midazolam , and propofol for outpatient colonoscopy . BACKGROUND This study tested the hypothesis that , for colonoscopy , analgesia/sedation with remifentanil and propofol might be more effective compared with anesthesia by intravenous administration of midazolam , fentanyl , and propofol . METHODS In a prospective , randomized trial , 100 adult patients received either conscious analgesia/sedation ( Sedation group ) or total intravenous anesthesia ( TIVA group ) . Analgesia/sedation was achieved by infusion of remifentanil ( 0.20 to 0.25 microg/kg/min ) and propofol in titrated doses . TIVA was induced by intravenous administration of fentanyl ( 2 microg/kg ) , midazolam ( 0.05 mg/kg ) and propofol ( dosage titrated ) . Cardiorespiratory parameters and bispectral index were monitored and recorded . The quality of the analgesia was assessed with a Numerical Pain Rating Scale ( NRS ) ; recovery level and return of psychomotor efficiency were evaluated with , respectively , the Aldrete scale and a Modified Post Anesthesia Discharge Scoring ( MPADS ) system . RESULTS Both groups of 50 patients were comparable with respect to demographic data , initial parameters , and duration of colonoscopy . All patients in the TIVA group found the colonoscopy painless ( NRS score 0 ) . In the Sedation group , the average pain intensity score was 0.4 ( 0.8 ) . There was a marked difference between the Sedation and TIVA groups with respect to the time from the end of the procedure until the maximum MPADS score was reached : respectively , -6.9 ( 4.0 ) versus 25.7 ( 8.4 ) minutes ( p < 0.001 ) . In the TIVA group , changes in mean arterial pressure and heart rate and signs of respiratory depression were significant ( p < 0.05 ) . CONCLUSIONS Combined administration of remifentanil and propofol for colonoscopy provides sufficient analgesia , satisfactory hemodynamic stability , minor respiratory depression , and rapid recovery , and allows patients to be discharged approximately 15 minutes after the procedure .
entities: 706
entities: Intervention_Pharmacological
entities: remifentanil
entities: 707
entities: Intervention_Pharmacological
entities: propofol
entities: 708
entities: Intervention_Pharmacological
entities: fentanyl
entities: 709
entities: Intervention_Pharmacological
entities: midazolam
entities: 710
entities: Intervention_Pharmacological
entities: propofol
entities: 711
entities: Intervention_Pharmacological
entities: remifentanil
entities: 712
entities: Intervention_Pharmacological
entities: propofol
entities: 713
entities: Intervention_Pharmacological
entities: midazolam
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entities: Intervention_Pharmacological
entities: fentanyl
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entities: Intervention_Pharmacological
entities: propofol
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entities: Intervention_Pharmacological
entities: remifentanil
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entities: Intervention_Pharmacological
entities: propofol
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entities: Intervention_Pharmacological
entities: fentanyl
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entities: Intervention_Pharmacological
entities: midazolam
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entities: Intervention_Pharmacological
entities: propofol
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entities: Intervention_Pharmacological
entities: remifentanil
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entities: Intervention_Pharmacological
entities: propofol
entities: 723
entities: Outcome_Physical
entities: Cardiorespiratory parameters
entities: 724
entities: Outcome_Physical
entities: bispectral index
entities: 725
entities: Outcome_Physical
entities: Numerical Pain Rating Scale ( NRS )
entities: 726
entities: Outcome_Physical
entities: recovery level
entities: 727
entities: Outcome_Physical
entities: return of psychomotor efficiency
entities: 728
entities: Outcome_Physical
entities: Aldrete scale
entities: 729
entities: Outcome_Physical
entities: Modified Post Anesthesia Discharge Scoring ( MPADS ) system
entities: 730
entities: Outcome_Pain
entities: pain intensity score
entities: 731
entities: Outcome_Physical
entities: maximum MPADS score
entities: 732
entities: Outcome_Physical
entities: mean arterial pressure and heart rate and signs of respiratory depression
entities: 733
entities: Outcome_Physical
entities: analgesia
entities: 734
entities: Outcome_Physical
entities: hemodynamic stability
entities: 735
entities: Outcome_Physical
entities: respiratory depression
entities: 736
entities: Outcome_Physical
entities: rapid recovery
entities: 737
entities: Participant_Condition
entities: outpatient colonoscopy .
entities: 738
entities: Participant_Sample-size
entities: 100
entities: 739
entities: Participant_Age
entities: adult patients