Comparison of the effects of bispectral index-controlled use of remifentanil on propofol consumption and patient comfort in patients undergoing colonoscopy.

Background And Study Aims: In endoscopic procedures, propofol can be safely administered either alone or in conjunction with remifentanil. The aim of the study is to compare the effects of the administration of propofol alone and the administration of remifentanil in addition to propofol on patient and endoscopist satisfaction, preoperative hemodynamic response, and propofol consumption.

Materials And Methods: A totally 60 patients were enrolled in the study. Propofol group (Group 1): A 0.4-mg/kg propofol bolus and 1 mg/kg/h maintenance infusion of propofol until a bispectral Index value of 70-75 was achieved. Propofol + remifentanil group (Group 2) received a 0.4 mg/kg propofol bolus dose and maintained with a 0.5 mg/kg/h infusion of propofol + 0.2 mcg/kg/min infusion of remifentanil. The infusion dose of remifentanil was maintained, and the propofol infusion dose was titrated until a BIS value of 70-75 was achieved.

Results: In Group 1 (colonoscopic intervention 1 and 5 min) and Group 2 (colonoscopic intervention 10 min.), main blood pressure (MBP) value has a significant decrease. Hypotension occurred in 6 patients in group 1, while 12 patients in group 2. No significant difference was found between the Patient's endoscopist' satisfaction, MBP and heart rate. Propofol consumption was greater in group 1 than in group 2. When the Ramsay sedation levels of Group 1 and Group 2 were compared, a statistically significant difference was observed.

Conclusions: The addition of remifentanil to propofol may be an alternative to the use of alone propofol for sedation in colonoscopic interventions.