Intravenous remifentanil and propofol for gastroscopy

To evaluate the efficiency and safety of intravenous (i.v.) remifentanil and propofol for gastroscopy in healthy adults.

Randomized, double-blinded study.

Endoscopy Center, West China Hospital, Sichuan University (Chengdu, People's Republic of China).

199 adult ASA physical status I and II patients.

Patients were randomly allocated to either the fentanyl group (n = 99) or the remifentanil group (n = 100). Patients received either fentanyl 0.5 microg/kg or remifentanil 0.5 microg/kg, followed by a bolus injection of one mg/kg of propofol. The subsequent doses of propofol were 0.5 mg/kg when the patient was conscious or body movement appeared.

Noninvasive blood pressure, heart rate, arterial pulse oxygen saturation, and respiratory rate were recorded before gastroscopy and at two-minute intervals until the end of the gastroscopy procedure. Patients were asked to evaluate their level of cognition using the Digit-Symbol Substitution Test score before gastroscopy and at 10 minutes after discontinuation of the drug injection.

Recovery time was significantly shorter in the remifentanil group than in the fentanyl group (P < 0.05). Postoperative Digit-Symbol Substitution Test scores were significantly higher in the remifentanil group than in the fentanyl group (P < 0.01). Total dosage of propofol given in the remifentanil group was significantly less than it was in the fentanyl group (P < 0.01). Frequency of apnea was significantly higher in the remifentanil group (P < 0.05). There were no significant differences in frequency of hypoxemia, bag ventilation, or body movement between the two groups (P > 0.05).

Intravenous remifentanil and propofol were more efficient for gastroscopy than i.v. fentanyl and propofol.