Hong Gwan Woo, Lee Jun Kyu, Lee Jung Hyeon, Bong Ji Hun, Choi Sung Hun, Cho Hyeki, Nam Ji Hyung, Jang Dong Kee, Kang Hyoun Woo, Kim Jae Hak, Lim Yun Jeong, Koh Moon Soo, Lee Jin Ho
Department of Internal Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang, Korea.
Clin Endosc. 2020 Sep;53(5):562-567. doi: 10.5946/ce.2020.022. Epub 2020 Jul 3.
BACKGROUND/AIMS: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy.
A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as the primary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes.
A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantly more rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min, p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001), but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal time and adenoma detection rate between the two groups.
The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.
背景/目的：咪达唑仑与阿片类药物联合应用广泛用于内镜检查镇静。据报道，与哌替啶相比，芬太尼与快速恢复、内镜检查室周转速度以及内镜检查质量相关。我们比较了芬太尼与哌替啶联合咪达唑仑用于镇静结肠镜检查的效果。
进行了一项回顾性、横断面、1:2匹配研究。将诱导和恢复时间作为主要结局进行比较。此外，将盲肠插管时间、退镜时间、结肠镜检查总操作时间、反常反应、腺瘤检出率以及咪达唑仑或阿片类药物的不良反应作为次要结局进行评估。
共有129名受试者（43例使用芬太尼 vs. 86例使用哌替啶）纳入分析。芬太尼组的诱导时间明显更快（4.5±2.7分钟 vs. 7.5±4.7分钟，p<0.001），但恢复时间比哌替啶组长（59.5±25.6分钟 vs. 50.3±10.9分钟，p=0.030）。在多变量分析中，芬太尼组的诱导时间比哌替啶组快3.40分钟（p<0.001），但恢复时间长6.38分钟（p=0.046）。两组的退镜时间和腺瘤检出率无差异。
与哌替啶组相比，芬太尼组的镇静诱导时间更快，但恢复时间更长。
