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Year : 2020  |  Volume : 40  |  Issue : 6  |  Page : 272-278

A Comparison of Two Proportions of Remifentanil–Propofol Mixture Administered with Target-Controlled Infusion for Patients Undergoing Colonoscopy

1 Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Republic of China
2 School of Medicine, Taipei Medical University, Taipei, Republic of China
3 Department of Anesthesiology, Chi Mei Medical Center; Department of the Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan City, Republic of China
4 Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Republic of China
5 Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei; Department of Anesthesiology, Chi Mei Medical Center, Tainan City; Department of Anesthesiology, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China

Correspondence Address:
Dr. Zhi-Fu Wu
No. 901, Zhonghua Rd., Yongkang Dist., Tainan City 71004
Republic of China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_27_20

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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.

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