Remifentanil vs. meperidine for patient-controlled analgesia during colonoscopy: A randomized double-blind trial

Lorella Fanti, Agostoni Massimo, Gemma Marco, Gambino Giulia, Facciorusso Antonio, Guslandi Mario, Torri Giorgio, Testoni Pier Alberto

Research output: Contribution to journalArticlepeer-review


Objectives: The aim was to compare patients and endoscopists satisfaction in terms of efficacy and safety of remifentanil patient-controlled analgesia (PCA) during colonoscopy with that of a combination of midazolam and meperidine. Methods: Sixty patients undergoing colonoscopy were randomly assigned to two groups. All of the patients received midazolam 0.03mgkg intravenously for premedication. In the remifentanil group, a bolus dose of remifentanil was given, and a patient-controlled sedation analgesia (PCSA) pump was set to inject further bolus doses with no lockout time. Patients in the meperidine group received a bolus of meperidine and sham PCSA. Non-invasive arterial blood pressure, electrocardiography, and pulse oximetry were monitored throughout the study. The Observer's Assessment of Alertness and Sedation Scale (OAAS) was performed at baseline, every 5min during, and after colonoscopy. Assessment of pain and satisfaction with sedoanalgesia was scheduled after colonoscopy and 24-72h later by a 100mm visual analog scale (VAS). The technical difficulty of the examination and the gastroenterologist's satisfaction were assessed similarly. Results: The degree of pain, the level of satisfaction with sedoanalgesia by patients and gastroenterologists, and the degree of difficulty experienced by the endoscopist were not different in the two groups. The time to reach an Aldrete score 9 was significantly shorter in the remifentanil group (P

Original languageEnglish
Pages (from-to)1119-1124
Number of pages6
JournalAmerican Journal of Gastroenterology
Issue number5
Publication statusPublished - May 2009

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)


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