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Conscious Sedation for Outpatient Colonoscopy

Phase 2
Completed
Conditions
Conscious Sedation
Interventions
Registration Number
NCT03925779
Lead Sponsor
Menoufia University
Brief Summary

Although colonoscopy is a mildly painful procedure, the pain and the procedure itself are distressful for most patients. This raises the attention for using different sedation regimens aiming at maintaining optimal sedation level with maintained airway and stable haemodynamics all through the procedure. The present study was scheduled to investigate the sedative efficacy of dexmedetomedine versus propofol-remifentanil for outpatient colonoscopy.

Detailed Description

Eighty patients undergoing outpatient colonoscopy will be randomized into two equal groups. In Dexmedetomidine (DEX) group the patients will be administered a loading dose of i.v. dexmedetomidine 1 μg/kg over 10 min, followed by a continuous infusion of 0.2-1 μg/kg/h, titrated according to the sedation score, till the end of the procedure. In the PR group, propofol will be started by a loading dose of 0.5 mg/kg over 3-5 minutes then a maintenance infusion of 25-75 μg kg/min. Remifentanil infusion will be started at 1 μg kg over one minute then and 0.01-0.1 μg kg/min. If the patient complained of pain or discomfort, the infusion rates of dexmedetomidine (DEX group) or propofol-remifentanil (P-R group) will be increased. If the higher limit of the dose range of the study drugs reached, additional fentanyl 0.5 μg/kg i.v. boluses will be administered. Rescue medication consisting of propofol boluses of 0.5 mg/kg i.v. will be given if the previous protocol failed. Sedation score,haemodynamics, end-tidal carbon dioxide, oxygen saturation, total fentanyl, propofol bolus doses, patient and colonoscopist satisfaction and side effects will be recorded.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • ASA I or II physical status
  • 18-65 years
  • Scheduled for elective colonoscopy
Exclusion Criteria
  • History of allergy to any of the study drugs
  • Alcohol or drug abuse.
  • Second and third-degree heart block.
  • Morbid obesity.
  • Pregnant and lactating women.
  • Psychiatric disorders.
  • Severe cardiac, respiratory, renal, and liver diseases

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
(Dexmedetomidine)Dex groupDexmedetomidineThe patients will be administered a loading dose of i.v. dexmedetomidine 1 μg/kg over 10 min, followed by a continuous infusion of 0.2-1 μg/kg/h, titrated according to the sedation score, till the end of the procedure
Propofol-Remifentanil (P-R) groupPropofolPropofol will be started by a loading dose of 0.5 mg/kg over 3-5 minutes then a maintenance infusion of 25-75 μg kg/min. Remifentanil infusion will be started at 1 μg kg over one minute then and 0.01-0.1 μg kg/min.
Propofol-Remifentanil (P-R) groupRemifentanilPropofol will be started by a loading dose of 0.5 mg/kg over 3-5 minutes then a maintenance infusion of 25-75 μg kg/min. Remifentanil infusion will be started at 1 μg kg over one minute then and 0.01-0.1 μg kg/min.
Primary Outcome Measures
NameTimeMethod
SedationPerioperative

Degree of sedation by Ramsay sedation score from 1 inadequate sedation to 6 excessive sedation.

Secondary Outcome Measures
NameTimeMethod
Oxygen saturationPerioperative

Arterial oxygen saturation as a percentage of the total haemoglobin.

HypotensionPerioperative

Number of patients with hypotension

BradycardiaPerioperative

Number of patients with bradycardia

Mean arterial blood pressurePerioperative

Mean arterial blood pressure in mmHg

Heart ratePerioperative

Heart rate in beats/minutes

AnalgesiaPerioperative

Measured by visual analogue scale \[from 0 "no pain" to 10 "worst imaginable pain"\]

Trial Locations

Locations (1)

Faculty of Medicine

🇪🇬

Cairo, Shebin El-kom, Egypt

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