Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial
Purpose: Colonoscopy is often accompanied by short-term postoperative cognitive decline. We aimed to explore whether single-use alfentanil for patients undergoing elective colonoscopy could reduce cognitive impairment at discharge compared with propofol. Patients and methods: 172 adult patients unde...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S240584402304269X |
| _version_ | 1827923840908394496 |
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| author | Xiwen Zhu Xuehan Chen Xuemei Zheng Hongyao Lyu Jie Chen Ai Yan Qi Liu Shiqi Li Yamei Zhang Ting Wang Guangyou Duan He Huang |
| author_facet | Xiwen Zhu Xuehan Chen Xuemei Zheng Hongyao Lyu Jie Chen Ai Yan Qi Liu Shiqi Li Yamei Zhang Ting Wang Guangyou Duan He Huang |
| author_sort | Xiwen Zhu |
| collection | DOAJ |
| description | Purpose: Colonoscopy is often accompanied by short-term postoperative cognitive decline. We aimed to explore whether single-use alfentanil for patients undergoing elective colonoscopy could reduce cognitive impairment at discharge compared with propofol. Patients and methods: 172 adult patients undergoing elective colonoscopy were randomized to receive intravenous propofol at 2 mg/kg (group P) or alfentanil at 10 μg/kg (group A); 40 healthy volunteers were included in the blank group. Cognitive function was considered the primary outcome and was measured using five neuropsychological tests before sedation and discharge. The z-score method was used to determine cognitive dysfunction according to z-score >1.96 in two types of neuropsychological tests. Other outcomes included discharge time, vital signs, associated adverse events during colonoscopy, and the satisfaction level of patients and endoscopic physicians. Results: 164 patients (78 in group A and 86 in group P) completed the study protocol. At discharge, the incidence of cognitive dysfunction in group P was 23% and was significantly lower in the alfentanil group (2.5%), with a relative risk of 0.11 (95% confidence interval: 0.03–0.46, P < 0.001). The incidence of hypotension in group A was lower than that in group P (3.8% vs 22.1%, relative risk = 0.17 [95% confidence interval: 0.05–0.46, P = 0.001]), and the discharge time in group A was shorter than that in group P (5 [(Rutter and et al., 2016; Zhang and et al., 2013; Hirsh and et al., 2006; Zhou and et al., 2021; Singh and et al., 2008; Ko and et al., 2010; Sargin et al., 2019) 3–93–9 vs 13 [(Ekmekci and et al., 2017; Eberl and et al., 2012; Eberl and et al., 2014; N'Kaoua and et al., 2002; Chung et al., 1995; Berger and et al., 2019; Quan and et al., 2019; Deng and et al., 2021; Gualtieri and Johnson, 2006) 10–1810–18 min, P < 0.001). Conclusion: For patients undergoing colonoscopy, single-use alfentanil causes less damage to postoperative cognitive function, less risk of hypotension, and shorter discharge time than propofol. |
| first_indexed | 2024-03-13T05:01:55Z |
| format | Article |
| id | doaj.art-9b40699c80054cab9cfaeee27ccf8bc1 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-13T05:01:55Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-9b40699c80054cab9cfaeee27ccf8bc12023-06-17T05:19:30ZengElsevierHeliyon2405-84402023-06-0196e17061Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trialXiwen Zhu0Xuehan Chen1Xuemei Zheng2Hongyao Lyu3Jie Chen4Ai Yan5Qi Liu6Shiqi Li7Yamei Zhang8Ting Wang9Guangyou Duan10He Huang11Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Preventive Medicine, West China School of Public Health, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Preventive Medicine, West China School of Public Health, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Psychology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China; Corresponding author.Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China; Corresponding author.Purpose: Colonoscopy is often accompanied by short-term postoperative cognitive decline. We aimed to explore whether single-use alfentanil for patients undergoing elective colonoscopy could reduce cognitive impairment at discharge compared with propofol. Patients and methods: 172 adult patients undergoing elective colonoscopy were randomized to receive intravenous propofol at 2 mg/kg (group P) or alfentanil at 10 μg/kg (group A); 40 healthy volunteers were included in the blank group. Cognitive function was considered the primary outcome and was measured using five neuropsychological tests before sedation and discharge. The z-score method was used to determine cognitive dysfunction according to z-score >1.96 in two types of neuropsychological tests. Other outcomes included discharge time, vital signs, associated adverse events during colonoscopy, and the satisfaction level of patients and endoscopic physicians. Results: 164 patients (78 in group A and 86 in group P) completed the study protocol. At discharge, the incidence of cognitive dysfunction in group P was 23% and was significantly lower in the alfentanil group (2.5%), with a relative risk of 0.11 (95% confidence interval: 0.03–0.46, P < 0.001). The incidence of hypotension in group A was lower than that in group P (3.8% vs 22.1%, relative risk = 0.17 [95% confidence interval: 0.05–0.46, P = 0.001]), and the discharge time in group A was shorter than that in group P (5 [(Rutter and et al., 2016; Zhang and et al., 2013; Hirsh and et al., 2006; Zhou and et al., 2021; Singh and et al., 2008; Ko and et al., 2010; Sargin et al., 2019) 3–93–9 vs 13 [(Ekmekci and et al., 2017; Eberl and et al., 2012; Eberl and et al., 2014; N'Kaoua and et al., 2002; Chung et al., 1995; Berger and et al., 2019; Quan and et al., 2019; Deng and et al., 2021; Gualtieri and Johnson, 2006) 10–1810–18 min, P < 0.001). Conclusion: For patients undergoing colonoscopy, single-use alfentanil causes less damage to postoperative cognitive function, less risk of hypotension, and shorter discharge time than propofol.http://www.sciencedirect.com/science/article/pii/S240584402304269XAlfentanilPropofolColonoscopyCognitive function |
| spellingShingle | Xiwen Zhu Xuehan Chen Xuemei Zheng Hongyao Lyu Jie Chen Ai Yan Qi Liu Shiqi Li Yamei Zhang Ting Wang Guangyou Duan He Huang Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial Heliyon Alfentanil Propofol Colonoscopy Cognitive function |
| title | Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial |
| title_full | Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial |
| title_fullStr | Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial |
| title_full_unstemmed | Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial |
| title_short | Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial |
| title_sort | effects of single use alfentanil versus propofol on cognitive functions after colonoscopy a randomized controlled trial |
| topic | Alfentanil Propofol Colonoscopy Cognitive function |
| url | http://www.sciencedirect.com/science/article/pii/S240584402304269X |
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