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Fentanyl or Tramadol, with Midazolam, for Outpatient Colonoscopy: Analgesia, Sedation, and Safety

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Abstract

The present study determined the acceptability of colonoscopy in outpatients treated with tramadol or fentanyl for analgesia and sedation. One hundred fifty patients were randomly assigned to receive midazolam, 0.05 mg/kg, and fentanyl, 2 μg/kg, intravenously (group 1), midazolam, 0.05 mg/kg, and tramadol, 1 mg/kg, per os (group 2), or midazolam, 0.05 mg/kg, and tramadol, 2 mg/kg, per os (group 3). Pain severity, level of sedation, cardiorespiratory parameters, and procedure-related side effects and complications were registered and analyzed. No significant cardiorespiratory disturbances were observed. Sedation level during the procedure was similar in all groups. Pain severity values measured during the procedure was significantly higher in groups 2 and 3 than in group 1 (P < 0.001). Both hospital and home adverse events occurred more frequently in groups 2 and 3 compared to group 1 (P < 0.03). The patients receiving fentanyl-based analgesia tolerated colonoscopy better than patients treated with tramadol.

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Acknowledgments

This work was supported by the Lady Davis Carmel Medical Center and the Center for Absorption in Science, Israeli Ministry of Immigrant Absorption. The authors are grateful to Ofra Barnett, Ph.D., and Ada Tamir, Ph.D., D.Sc. for statistical assistance, and to Mark Hirsh, M.D., Ph.D., for his help in preparing the manuscript.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center, and The B. & R. Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

    Irina Hirsh, Josef Chernin & Reuven Pizov

  2. Department of Gastroenterology, Lady Davis Carmel Medical Center, and The B. & R. Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

    Alexander Vaissler & Ori Segol

  3. Department of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center, 7 Michal Street, Haifa, 34362, Israel

    Irina Hirsh

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  1. Irina Hirsh
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  2. Alexander Vaissler
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  3. Josef Chernin
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  4. Ori Segol
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  5. Reuven Pizov
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Correspondence to Irina Hirsh.

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Hirsh, I., Vaissler, A., Chernin, J. et al. Fentanyl or Tramadol, with Midazolam, for Outpatient Colonoscopy: Analgesia, Sedation, and Safety. Dig Dis Sci 51, 1946–1951 (2006). https://doi.org/10.1007/s10620-006-9413-9

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  • DOI: https://doi.org/10.1007/s10620-006-9413-9

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