RESUMO
Objectives: Propofol and midazolam are popular sedatives in colonoscopy. Our aim was to measure depth of sedation with propofol-fentanyl and midazolam-fentanyl in patients undergoing colonoscopy using a blinded electroencephalogram [EEG]-based SEDLine monitor
Design: Non-randomized, prospective, observational
Setting: Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
Subjects: One hundred and eight adult volunteers with American Society of Anesthesiologist [ASA] class I-II-III, aged 18 - 80 years, and undergoing colonoscopy with propofol-fentanyl [Group P] or midazolam-fentanyl [Group M] -based sedation Interventions: Demographic variables, depth of sedation and recovery times were recorded
Main outcome measures: Depth of sedation was measured and recorded with an EEG-based SEDLine monitor. Patient State Index [PSI] values at colonoscope insertion, removal, and at return of verbal responsiveness after colonoscope withdrawal were documented
Results: Patients in group P were younger [p <0.0001] and had lower ASA scores [p = 0.02] than group M patients. Group P patients experienced signi.cantly deeper degrees of sedation at all times and longer sedation and recovery times [p <0.0001 and p = 0.01]. Group P patients were more deeply sedated and had lower PSI values at the 5th minute [p <0.0001] and lower PSI scores after recovery [p <0.0001]. Group M had more comorbidity but more stable PSI values. Their sedation levels were also closer to normal
Conclusion: Clinical signs for sedation showed that propofol was over-used. The titration of propofol using a processed-EEG monitor, such as SEDLine, can improve sedation procedures by reducing time spent in states of deep sedation/general anesthesia while maintaining the clinical advantages of propofol