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Value of Fentanyl in Flexible Sigmoidoscopy

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Abstract

Studies have recorded significant patient discomfort during flexible sigmoidoscopy when it is performed without sedation/analgesia. This study observed whether a single dose of 50 mcg intravenous fentanyl reduces pain, improving compliance, acceptability, and completion rates. In a prospective study, 109 consecutive patients were offered the option of 50 mcg intravenous fentanyl or no analgesia. Patient’s pre-procedure expectations, objective pain scores, and willingness to undergo a subsequent procedure using the same technique were recorded. Endoscopist recorded the success, complications, and objective pain scores for each patient. Of the 46 patients (42%) choosing fentanyl, 9 (20%) experienced moderate/severe pain as against 26(41%) of the 63 patients (58%) opting for no analgesia (p < 0.05). Further, 52% receiving fentanyl had a significantly better experience compared to their pre-procedure expectations as against 33% who received no analgesia (p < 0.05). No patient receiving fentanyl expressed unwillingness to undergo the procedure again using the same technique, whereas 16 (25%) of those receiving no analgesia indicated they would not (p < 0.01). Endoscopists recorded moderate/severe pain in 13 patients (12%), whereas 35 patients (32%) recorded moderate/severe pain (p < 0.001). Analgesia for endoscopy should involve patient choice. However, a single dose of 50 mcg fentanyl reduced patient discomfort and improved satisfaction. It appeared safe and likely to improve patient compliance and acceptability for flexible sigmoidoscopy.

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Acknowledgments.

We extend our sincere thanks to all the staff of the Endoscopy Unit, St Mary’s Hospital, Newport, Isle of Wight, for their cooperation and hard work in getting this study completed.

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Authors and Affiliations

  1. Endoscopy Unit, St Mary’s Hospital, PO30 5TG, Isle of Wight, UK

    Sanjoy Basu M.S., FRCS, Badri Krishnamurthy M.S., FRCS & Tim H. Walsh M.S., FRCS

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  1. Sanjoy Basu M.S., FRCS
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  2. Badri Krishnamurthy M.S., FRCS
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  3. Tim H. Walsh M.S., FRCS
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Correspondence to Sanjoy Basu M.S., FRCS.

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Basu, S., Krishnamurthy, B. & Walsh, T. Value of Fentanyl in Flexible Sigmoidoscopy. World J. Surg. 28, 930–934 (2004). https://doi.org/10.1007/s00268-004-7374-8

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