Patient-controlled analgesia and sedation with alfentanyl versus fentanyl for colonoscopy: a randomized double blind study

J Clin Gastroenterol. 2011 Aug;45(7):e72-5. doi: 10.1097/MCG.0b013e318201fbce.


Study objective: The aim of this study was to evaluate whether sedo-analgesia with alfentanyl/fentanyl, using a patient-controlled analgesia (PCA) pump, may have positive outcomes in terms of safety, postprocedural workload, and expectations of the colonoscopist, nurse, and patients in elective colonoscopy.

Patients: One hundred American Society of Anesthesiology physical status I and II adult patients.

Interventions: Patients were randomized in a double-blind trial to receive either alfentanyl (n=50) or fentanyl (n=50) by PCA, and incremental doses of midazolam.

Measurements: Patient expectations were assessed using hemodynamic variables, willingness to have a repeat colonoscopy in the same way, adverse events, discomfort scores, and patient/operator/nurse satisfaction associated with sedo-analgesia.

Result: All patients in both groups had adequate sedo-analgesia with high satisfaction and willingness scores. There were no serious adverse effects and except for a few events, no required medication. The total sedation times were shorter in the alfentanyl group compared with the fentanyl group.

Conclusions: PCA and sedation with alfentanyl and fentanyl for colonoscopy are safe, feasible, and acceptable to most patients. However, shorter sedation times make alfentanyl more attractive for postprocedural workload.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alfentanil / administration & dosage*
  • Analgesia, Patient-Controlled / methods*
  • Analgesics, Opioid / administration & dosage*
  • Anesthetics, Intravenous / administration & dosage
  • Colonoscopy*
  • Conscious Sedation / methods*
  • Double-Blind Method
  • Female
  • Fentanyl / administration & dosage*
  • Humans
  • Male
  • Midazolam / administration & dosage
  • Middle Aged
  • Patient Satisfaction
  • Treatment Outcome


  • Analgesics, Opioid
  • Anesthetics, Intravenous
  • Alfentanil
  • Midazolam
  • Fentanyl