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A Comparison between Etomidate and Propofol for Sedation in Colonoscopy

Swati Bisht* , Swati Bisht* , Sadanand Gopal*

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Indian Journal of Anesthesia and Analgesia 4(2):p 295-299, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.19

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Abstract

 Background: Propofol has been the widely used sedative agent for colonoscopy.However, in elderly population, propofol causes an exaggerated cardiorespiratory depression. Etomidate causes sedation with minimal effect on cardiovascular and respiratory system. Objective: The primary objective was to compare the hemodynamic, respiratory and recovery profiles of Etomidate versus Propofol for sedation in colonoscopy. Secondary objective was to evaluate the effect on pain post colonoscopy with these drugs. Materials and Methods: Sixty patients aged 60 years and above, for colonoscopy were randomly divided into two groups.All patients received fentanyl 1mcg/kg. Group E received etomidate 0.1mg/kg over one minute, followed by 5­10 mcg/ kg/minute. Group P received propofol 0.5mg/kg over one minute, followed by 0.05mg/ kg/minute. Colonoscope was inserted when Ramsay sedation score was 4. The time required for induction, vitals every 5 minutes, and the time for modified aldrette score to reach 9 were noted. Visual analog pain score was assessed in all patients. Results: During the procedure the fall in heart rate, mean arterial pressure was significantly more in group P than in group E (p <0.001). The fall in oxygen saturation was greater in group P but was not significant. The time taken to induce the patients was the same in the two groups.The recovery time was significantly longer in group E(p<0.001). There was no difference in the visual analog score of pain. Bradycardia, hypotension and hypoxia were encountered in group P. Conclusion: Etomidate fentanyl sedation is safer than propofol fentanyl combination in elderly patients undergoing colonoscopy.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.19

Keywords

Etomidate; Propofol; Fentanyl; Colonoscopy.

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