Analgesic Effect and Hemodynamic Changes Due to Dexmedetomidine Versus Fentanyl During Elective Colonoscopy: A Double-Blind Randomized Clinical Trial

BACKGROUND: There are different methods used for anesthesia during a colonoscopy procedure. OBJECTIVES: The aim of this study was to compare the analgesic effect and hemodynamic changes due to dexmedetomidine and fentanyl during elective colonoscopy. METHODS: This double-blind clinical trial was conducted on 80 patients aged 20 - 70 years, candidates for elective colonoscopy, who were randomly divided into two equal groups. In the intervention group (group D), dexmedetomidine 1 mcg/kg was given 10 minutes before starting the colonoscopy and then, 0.5 mcg/kg/hour during colonoscopy was prescribed. In the control group (group F), fentanyl 0.5 mcg/kg was prescribed three minutes before starting the colonoscopy and then, the normal saline infusion was used as maintenance. Propofol 20 mg was prescribed as the rescue dose if needed (pain or severe discomfort during colonoscopy) during the procedure. Demographic and basic clinical data and blood pressure, heart rate, respiratory rate, peripheral oxygen saturation (SpO(2)), and pain score (based on the visual analogue scale) were recorded from the start of the colonoscopy (time 0) and every 5 minutes until the recovery. RESULTS: The two groups had no significant difference in the duration of colonoscopy, colonoscopist’s satisfaction, and patients’ satisfaction (P > 0.05). The mean pain score during colonoscopy was lower in the dexmedetomidine group (P = 0.039). Heart rate was less in the dexmedetomidine group than in the fentanyl group and this difference was statistically significant. The mean arterial pressure had no difference between the two groups. CONCLUSIONS: The results of the present study showed pain score was lower in the dexmedetomidine group than in the fentanyl group.