A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy
Background: Previous studies have demonstrated the feasibility of a remifentanil–propofol (RP) mixture use in sedation for medical examinations. However, delivery of an RP mixture by target-controlled infusion (TCI) for colonoscopy has not been described. Here, we investigate the appropriate proport...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Journal of Medical Sciences |
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| Online Access: | http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2020;volume=40;issue=6;spage=272;epage=278;aulast=Lai |
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| author | Hou-Chuan Lai Tsai-Shan Wu Meng-Fu Lai Yi-Hsuan Huang Jen-Yin Chen Yao-Tsung Lin Zhi-Fu Wu |
| author_facet | Hou-Chuan Lai Tsai-Shan Wu Meng-Fu Lai Yi-Hsuan Huang Jen-Yin Chen Yao-Tsung Lin Zhi-Fu Wu |
| author_sort | Hou-Chuan Lai |
| collection | DOAJ |
| description | Background: Previous studies have demonstrated the feasibility of a remifentanil–propofol (RP) mixture use in sedation for medical examinations. However, delivery of an RP mixture by target-controlled infusion (TCI) for colonoscopy has not been described. Here, we investigate the appropriate proportion of RP mixed regimens, prepared in two different ratios for colonoscopy. Methods: A retrospective study including patients who received a colonoscopy between May 2018 and January 2019 was conducted. Group 1 and Group 2 were, respectively, administered a mixture of RP at concentrations of 2.5 μg/mL-10 mg/mL and 5.0 μg/mL-10 mg/mL by adjusting a TCI pump with Schneider model to keep the Observer's Assessment of Alertness/Sedation scale between 1 and 2. The primary outcome was to determine the appropriate proportion of RP for the procedure in terms of hemodynamic conditions and adverse events. The secondary endpoints included the total dosage of anesthetics and total times of TCI pump adjustments. Results: A total of 120 patients in Group 1 and 116 patients in Group 2 were eligible for analysis. Several parameters were significantly different between Group 1 and Group 2, with Group 1 having a higher respiratory rate, a lower end-tidal carbon dioxide pressure, fewer patients with hypotension (mean arterial pressure <60 mmHg; 1 vs. 7, P = 0.033) or apnea with desaturation (peripheral oxygen saturation < 90%; 1 vs. 12, P = 0.001), more propofol consumption (162.4 ± 49.6 mg vs. 130.3 ± 48.8 mg, P < 0.001), less remifentanil consumption (40.6 ± 12.3 μg vs. 65.1 ± 24.4 μg, P < 0.001), and fewer total times of TCI pump adjustment (1 [0–1] vs. 1 [1–2], P < 0.001), as compared to Group 2. Conclusions: In colonoscopy, TCI with an RP mixed regimen prepared in the proportion of 2.5 μg/mL-10 mg/mL with propofol Schneider model target 2.5–3.0 μg/mL provided appropriate hemodynamic conditions, sufficient sedation and analgesia, and less adverse events. |
| first_indexed | 2024-12-12T07:12:03Z |
| format | Article |
| id | doaj.art-30dede9e8bfa4f929126ba967233d58f |
| institution | Directory Open Access Journal |
| issn | 1011-4564 |
| language | English |
| last_indexed | 2024-12-12T07:12:03Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Medical Sciences |
| spelling | doaj.art-30dede9e8bfa4f929126ba967233d58f2022-12-22T00:33:36ZengWolters Kluwer Medknow PublicationsJournal of Medical Sciences1011-45642020-01-0140627227810.4103/jmedsci.jmedsci_27_20A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing ColonoscopyHou-Chuan LaiTsai-Shan WuMeng-Fu LaiYi-Hsuan HuangJen-Yin ChenYao-Tsung LinZhi-Fu WuBackground: Previous studies have demonstrated the feasibility of a remifentanil–propofol (RP) mixture use in sedation for medical examinations. However, delivery of an RP mixture by target-controlled infusion (TCI) for colonoscopy has not been described. Here, we investigate the appropriate proportion of RP mixed regimens, prepared in two different ratios for colonoscopy. Methods: A retrospective study including patients who received a colonoscopy between May 2018 and January 2019 was conducted. Group 1 and Group 2 were, respectively, administered a mixture of RP at concentrations of 2.5 μg/mL-10 mg/mL and 5.0 μg/mL-10 mg/mL by adjusting a TCI pump with Schneider model to keep the Observer's Assessment of Alertness/Sedation scale between 1 and 2. The primary outcome was to determine the appropriate proportion of RP for the procedure in terms of hemodynamic conditions and adverse events. The secondary endpoints included the total dosage of anesthetics and total times of TCI pump adjustments. Results: A total of 120 patients in Group 1 and 116 patients in Group 2 were eligible for analysis. Several parameters were significantly different between Group 1 and Group 2, with Group 1 having a higher respiratory rate, a lower end-tidal carbon dioxide pressure, fewer patients with hypotension (mean arterial pressure <60 mmHg; 1 vs. 7, P = 0.033) or apnea with desaturation (peripheral oxygen saturation < 90%; 1 vs. 12, P = 0.001), more propofol consumption (162.4 ± 49.6 mg vs. 130.3 ± 48.8 mg, P < 0.001), less remifentanil consumption (40.6 ± 12.3 μg vs. 65.1 ± 24.4 μg, P < 0.001), and fewer total times of TCI pump adjustment (1 [0–1] vs. 1 [1–2], P < 0.001), as compared to Group 2. Conclusions: In colonoscopy, TCI with an RP mixed regimen prepared in the proportion of 2.5 μg/mL-10 mg/mL with propofol Schneider model target 2.5–3.0 μg/mL provided appropriate hemodynamic conditions, sufficient sedation and analgesia, and less adverse events.http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2020;volume=40;issue=6;spage=272;epage=278;aulast=Lairemifentanilpropofoltarget-controlled infusioncolonoscopy |
| spellingShingle | Hou-Chuan Lai Tsai-Shan Wu Meng-Fu Lai Yi-Hsuan Huang Jen-Yin Chen Yao-Tsung Lin Zhi-Fu Wu A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy Journal of Medical Sciences remifentanil propofol target-controlled infusion colonoscopy |
| title | A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy |
| title_full | A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy |
| title_fullStr | A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy |
| title_full_unstemmed | A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy |
| title_short | A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy |
| title_sort | comparison of two proportions of remifentanil propofol mixture administered with target controlled infusion for patients undergoing colonoscopy |
| topic | remifentanil propofol target-controlled infusion colonoscopy |
| url | http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2020;volume=40;issue=6;spage=272;epage=278;aulast=Lai |
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