249 outpatients at the Valduce Hospital in Como, who were due for colonoscopy, were randomly assigned to one of two groups.
125 patients (Group A) received intravenous midazolam, 0.07mg/kg, and meperidine, 0.77mg/kg, immediately before the insertion of the colonoscope.
The remaining 124 patients (Group B) received the same medication on request during colonoscopy.
|Patients reporting moderate/severe pain:|
34% receiving sedation on demand
12% receiving routine sedation
Patients were telephoned 24 hours after the procedure, and interviewed by a nurse to evaluate tolerance of the procedure.
83 of 124 patients (66%) in Group B required sedation during colonoscopy.
The proportion of patients reporting moderate or severe pain during colonoscopy was significantly higher in Group B (34%) than in Group A (12%).
More than 22% of patients in Group B said they would not be willing to undergo the test again, compared to only 9.7% in Group A.
There was no significant difference in side-effects between the two groups.
Dr Vittorio Terruzzi, who led the research, concludes, "Administration of sedative and analgesic drugs routinely before colonoscopy is superior to on demand sedation in terms of tolerance and is not associated with an increase in side-effects."