Randomized clinical trial of Entonox ® versus midazolam-fentanyl sedation for colonoscopy

Maslekar, S.; Gardiner, A.; Hughes, M.; Culbert, B.; Duthie, G. S.

Abstract

Background: Intravenous sedation for colonoscopy is associated with cardiorespiratory complications and delayed recovery. The aim of this randomized clinical trial was to compare the efficacy of Entonox ® (50 per cent nitrous oxide and 50 per cent oxygen) and intravenous sedation using midazolam-fentanyl for colonoscopy. Methods: Some 131 patients undergoing elective colonoscopy were included. Patients completed a Hospital Anxiety and Depression questionnaire, letter cancellation tests and pain scores on a 100-mm visual analogue scale before, immediately after the procedure and at discharge. They also completed a satisfaction survey at discharge and 24 h after the procedure. Results: Sixty-five patients were randomized to receive Entonox ® and 66 to midazolam-fentanyl. Completion rates were similar (94 versus 92 per cent respectively; P = 0.513). Patients receiving Entonox ® had a shorter time to discharge. They reported significantly less pain (mean score 16.7 versus 40.1; P < 0.001), and showed better recovery of psychomotor function immediately after the procedure and at discharge. Patient satisfaction was higher among patients who received Entonox ® (median score 96 versus 89; P = 0.001). Conclusion: Entonox ® provides better pain relief and faster recovery than midazolam-fentanyl and so is more effective for colonoscopy. Registration number: ISRCTN81142957 (http://www.controlled-trials.com).

Citation

Maslekar, S., Gardiner, A., Hughes, M., Culbert, B., & Duthie, G. S. (2009). Randomized clinical trial of Entonox ® versus midazolam-fentanyl sedation for colonoscopy. British journal of surgery, 96(4), 361-368. https://doi.org/10.1002/bjs.6467

• Journal Article Type: Article
• Acceptance Date: Feb 23, 2009
• Online Publication Date: Mar 12, 2009
• Publication Date: 2009-04
• Deposit Date: Nov 13, 2014
• Journal: British Journal Of Surgery
• Print ISSN: 0007-1323
• Electronic ISSN: 1365-2168
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 96
• Issue: 4
• Pages: 361-368
• DOI: https://doi.org/10.1002/bjs.6467
• Keywords: REF 2014 submission**
• Public URL: https://hull-repository.worktribe.com/output/461481