Conscious sedation/analgesia with target-controlled propofol and remifentani for colonoscopy in elderly

Objective To study the efficacy and safety with conscious sedation/analgesia using target-controlled infusion (TCI) of propofol and remifentanil for colonoscopy in elderly. Methods Seventy elder candidates (ASA I-III) for colonoscopy were randomized into two groups (n=35 each): anesthesia group (group T) and control group (group C). Colonoscopy was started after Ramsay score 2 was achieved. For group T, TCI was given with propofol maintained at 0.4 ~ 1.0μg/ml and remifentanil at 0.4~0.9 ng/ml, and was discontinued when colonoscope reached ileocecal valve. Group C underwent colonoscopy without anesthesia. Results 85.7% of patients in group T and 20% in group C achieved Ramsay score 2 (P0.01). Compared with group C, group T showed lower visual analogue scales (VAS) (P0.01), shorter operating duration, reduced SBP, DBP and HR at colonoscopy (P0.05 or 0.01), lower BIS (P0.01) but no elevation in blood sugar level (P0.05). Higher success rate and percentage of satisfaction from patients and physicians were also noted in group T. Conclusion TCI with propofol/remifentanil for colonoscopy in the elderly may provide favorable outcomes in terms of conscious sedation/analgesia, hemodynamics, stress reaction, operative duration, success rate as well as patient acceptance and compliance. Therefore, this is a safe, effective and feasible option for anesthesia.