Comparison of Three Premedication Regimens for Pain Relief and Patient's Satisfaction During Routine Colonoscopy

Abstract

Background: To perform screening for colonic cancer and to diagnose other colic diseases, colonoscopies are required. Comfort of patient during colonoscopy is very important. Currently, there are two types of sedation used during colonoscopy-the general anesthesia and sedoanalgesia. Sedo-analgesia is the most frequently used type of sedation employed during colonoscopy worldwide.

Materials and Methods: In a double-blinded randomized clinical trial, 145 patients underwent colonoscopy were randomly assigned to four treatment arms. Group A patients received 50 mg hydroxyzine orally. Group B patients received 50 mg hydroxyzine orally and 25 mg pethidine intravenously. Group C patients were administered 25 mg pethidine intravenously and patients in group D were given 25 mg pethidine plus 2.5 mg midazolam intravenously. The patient satisfaction was then evaluated using a GHAA-9 questionnaire and measuring the pain by a visual analogue scale.

Results: There were differences among the three groups. Sedation with hydroxyzine alone or in combination with pethedine resulted in a significantly better satisfaction (p‹0.05). The excellent score for the patient satisfaction was 84.3% in hydroxyzine group, 64.9% in hydroxyzine+pethidine group, 5.7% in pethidine group and 5.7% in pethidine+midazolam group.

Conclusion: Oral hydroxyzine is more effective than combinations of a narcotic and benzodiazepine in provision of pain relief and achievement of patient satisfaction in colonoscopy. Hydroxyzine is an excellent alternative to traditional intravenous drugs.