Intranasal versus intravenous sufentanil for analgesia-sedation in patients undergoing fiberoptic colonoscopy

Objective To compare the analgesia and sedation produced by intranasal and intravenous sufentanil in patients undergoing fiberoptie colonoscopy.Methods Sixty ASA I or Ⅱ patients aged 32-78 yr weighing 50-85 kg were randomly divided into 3 groups(n=20 each):group I received sufentanil 0.1ug/kg injected slowly iv;groupⅡand Ⅲ received intranasal instillation of sufentanil 0.13 and 0.1 ug/kg respectively.Sufentanil was diluted to 1 ml in all 3 groups.Lidoene 50 mg and propofol 1-3 mg/ks were then injected slowly iv until consciousness was lost and eyelash reflex disappeared.Fibemptic eolonoscopy was started.Sedation was maintained with continuous infusion of propofol at 50ug·kg-1·min-1.Intermittent iv boluses of propofol 0.5-1.0 mg/ks were givefi during operation when necessary.MAP,HR and Sp02 were continuously monitored and recorded before(To,baseline)and 2,3,4 min after sedation was induced (TI.2.3) and when the patients were awake(T4).The level of sedation was assessed using obselrvr's assessment of alertness/sedation scale(OAA/S).Body movement in response to surgical stimuli,awakening time,side effects,the amount of propofol used for induction of sedation and the total amount of propofol used during operation were recorded and compared amongthe 3 groups.Results The 3 groups were comparable with respect to age,sex ratio,body weight and height.There were no significant differences in duration of colonoscopy,awakening time,the amount of propofol used for induction,the total amount of propofol and OAA/S scores among the 3 groups.There were no postoperatye nausea and vomiting and somnolence.SpO2 was significantly lower at Tl in group I than in group Ⅱ and Ⅲ,but there was no sisnificant difference in SpO2 at all time points between group Ⅱ and Ⅲ.MAP was significantly decreased at T1-4 as compared with the baseline at To in all 3 groups.Conclusion Sufentanil 0.1 ug/kg administered intranasally is better than that given iv in terms of respiratory depression. Key words: Sufentanil; Administration,intranasal; Endoscopy,gastrointestinal