Additive Effects of Clonidine Used in Propofol Sedation in Colonoscopy.

BACKGROUND

Propofol is commonly used for sedation during colonoscopy but often requires high doses.

OBJECTIVES

This study aimed to compare the outcomes of propofol alone versus propofol combined with clonidine for colonoscopy sedation.

METHODS

In this randomized, double-blind controlled trial, 60 adult patients scheduled for elective colonoscopy were enrolled. Patients were divided into two groups: Group 1 (G1) received propofol alone, while group 2 (G2) received propofol plus 2 μg/kg clonidine intravenously over 10 minutes. Propofol infusion was initiated at 25 - 75 μg/kg/min IV for the first 10 - 15 minutes, then titrated to 25 - 50 μg/kg/min based on clinical response.

RESULTS

Sedation onset was significantly faster in G2 than in G1 (P = 0.001). The total propofol requirement was 22% lower in G2 (P = 0.001). Heart rate (HR) and mean arterial pressure (MAP) were significantly lower in G2 at induction and at the end of the procedure (P < 0.05). Patient satisfaction scores were higher in G2 (P = 0.042). The observer's assessment of alertness/sedation (OAA/S) score after induction was lower in G2 (P = 0.015), indicating deeper sedation. However, Aldrete scores in the post-anesthesia care unit (PACU) were lower in G2 (P = 0.001), suggesting a slower recovery.

CONCLUSIONS

The addition of clonidine to propofol for colonoscopy sedation led to faster sedation onset, reduced propofol requirements, improved patient satisfaction, and deeper sedation, but with potentially prolonged recovery times.