Dexmedetomidine versus Propofol in Combination with Fentanyl for Sedation-Analgesia in Colonoscopy Procedures: A Randomized Prospective Study

Elham Kavousi, Hamid Reza Shariefnia, Pejman Pourfakhr, Mohamadreza Khajavi, Alireza Behseresht



Colonoscopy is an uncomfortable and short procedure needing brief sedation with fast emergence.


This research is going to measure intravenous dexmedetomidine against propofol-fentanyl combination in terms of sedation-analgesia and hemodynamic changes in non-obligatory colonoscopy procedures. 70 colonoscopy candidates aged between 20 to 70 years were enrolled in this study while separated into two random equal-sized groups (p stands for propofol- & D stands for dexmedetomidine groups). All patients were premedicated with 0.03 mg/kg midazolam and 1 µ/kg fentanyl, 10 minutes and 5 minutes before the colonoscopy process, respectively. 0.5-1 mg/kg propofol for the P group and 1 µ/kg dexmedetomidine for the D group were infused in one minute before the initiation of the procedure following by normal saline as maintenance liquid and boluses of 25-50 µg fentanyl as needed.


These variables were entered into a datasheet: hemodynamic changes, sedation-analgesia level throughout the procedure, and patients' and physicians' contentment. The mean arterial pressure changes were similar and insignificant in the two groups (82.44±12.34 vs. 87.63±22.45 p=0.2). The D group had lower heart rates in comparison with the P group (72.51±16.7 vs. 81.56±15.71 p=0.001). The P group was deeply to moderately sedated and required a significantly lower doses of fentanyl rescue treatment (71.02±25.63 vs. 91.45±38.62 µg p=0.003). The P group was associated with a high incidence of apnea and was significantly superior to the D group in the matter of satisfaction (43% against 77%).


Colonoscopists' contentment rates were identical in both groups. Propofol infusion is more satisfactory yet having more respiratory depression possibility in comparison with dexmedetomidine infusion in colonoscopy candidates.


Colonoscopy; Contentment; Dexmedetomidine; Propofol; Sedation-analgesia

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