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Clinical trial: a randomized, study comparing fentanyl and meperidine in adult gastrointestinal endoscopy.

Author(s): Robertson DJ, Jacobs DP, Mackenzie TA, Oringer JA, Rothstein RI

Affiliation(s): VA Medical Center, White River Junction VT and Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon NH.

Publication date & source: 2009-01-20, Aliment Pharmacol Ther., [Epub ahead of print]

Background: There is little evidence to guide choice between meperidine and fentanyl for sedation for gastrointestinal endoscopy Aim: To compare meperidine to fentanyl in terms of procedure time and analgesia. Methods: Single center randomized controlled trial. Patients received narcotic doses and midazolam at the discretion of the attending endoscopist who was unaware of narcotic assignment. Endoscopy and recovery times were then recorded The main outcome was total procedure time-defined as endoscopy time plus recovery time. Patient discomfort was assessed prior to discharge via visual analog scale. Results: In total, 55 patients were randomized to meperidine (44 colonoscopy and 11 EGD)and 56 to fentanyl (45 colonoscopy and 11 EGD). Total procedure time was shorter for those receiving fentanyl (mean = 87.7 minutes) as compared to Demerol (mean = 102.9 minutes) (p=0.05). The difference between the groups was explained by a shorter mean recovery time in the fentanyl group (63.0 minutes) vs. the meperidine group (76.2 minutes) (p-0.07). Based on post procedure pain scores exams with meperidine (mean= 1.99) were less painful when compared those receiving fentanyl (mean =2.86, p=0.03). Conclusion: Fentanyl shortened total procedure time by reducing recovery time. A simple change in narcotic choice could increase endoscopy unit efficiency.

Page last updated: 2009-02-08

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