Sedação venosa Versus anestesia venosa em colonoscopia

Abstract

Introduction: Sedation and anesthesia for colonoscopy are common practices around the world, but there is no consensus on the choice of the regime and the appropriate drugs and doses that are administered safely and effectively, to achieve patient comfort and at the same time cause the least possible complications. Objectives: Comparing mild sedation with anesthesia, both intravenous, using different drugs in colonoscopy. Methods: Prospective, observational and comparative study of 90 patients submitted to colonoscopy. A group of 47 patients received intravenous sedation with midazolam and fentanyl, and the other composed of 43 patients received intravenous anesthesia with porpofol, midazolam and fentanyl. The patients had their blood pressure, heart rate, respiratory rate and oxygen saturation monitored.Results: The groups were composed mostly by women and patients without comorbidities. The group of anesthesia was formed by patients, on average 10 years old (p <0.001). Complications were significantly more numerous in anesthesia group (40%) compared to sedation (19%). Prolonged time (> 10min) examination and doses greater than 10ml of propofol related to a higher rate of complications. The standard methods was, in general, good and excellent, but the anesthetized patients were more comfortable during the colonoscopy. The cost was higher in the anesthesia group. Conclusions: A moderate intravenous sedation and intravenous anesthesia practices are safe and effective, beacause for most patients tolerate the examination well and does not need hospitalization. Anesthesia cause more comfort, but is associated with important numbers of minor complications and higher cost.