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Alfentanil-Propofol Versus Sufentanil-Propofol Sedation on Postoperative Fatigue After Gastrointestinal Endoscopy: A
Mengyi Li1, Rui Zhang1, Zongqin Zheng1
1Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Purpose:
Opioid-propofol sedation is standard for gastrointestinal endoscopy but may contribute to postoperative fatigue (POF). This study compared the severity of POF between sufentanil-propofol and alfentanil-propofol sedation in patients undergoing gastrointestinal endoscopy.
Methods:
In this randomized trial, 248 patients scheduled for esophagogastroduodenoscopy and/or colonoscopy received either alfentanil (7.5-10 μg/kg) or sufentanil (0.1-0.2 μg/kg) combined with propofol for deep sedation. The primary outcome was POF severity assessed by the Christensen Fatigue Scale (CFS) 30 min post-procedure. Secondary outcomes included recovery times (awakening and ambulation), incidence of clinically significant fatigue (CFS ≥ 6), and adverse events.
Results:
At 30 min post-procedure, the alfentanil group had significantly lower CFS scores than the sufentanil group (mean [standard deviation, SD]: 4.7 [1.0] vs. 5.7 [1.0]; mean difference -1.1, 95% CI -1.3 to -0.8; P < 0.001). The proportion of patients with CFS score ≥ 6 was also lower in the alfentanil group (20.8% vs. 35.7%, P = 0.004). Recovery was faster in the alfentanil group for both awakening (3.0 [2.2] vs. 5.5 [2.8] minutes, P < 0.001) and ambulation (12.8 [2.4] vs. 15.7 [3.4] minutes, P < 0.001). Adverse events including dizziness, nausea, and vomiting were less frequent with alfentanil (15.2% vs. 26.0%, P = 0.035; and 4.8% vs. 12.2%, P = 0.036).
Conclusions:
Compared to sufentanil, alfentanil combined with propofol significantly reduced postoperative fatigue and enhanced recovery in patients undergoing deeply sedated gastrointestinal endoscopy.
Registration:
Name of trial registry: Chinese Clinical Trial Registry.
Registration Number:
ChiCTR2300071429. URL: https://www.chictr.org.cn/showproj.html?proj=186791.
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