Digestive Diseases and Sciences

, Volume 51, Issue 11, pp 1946–1951 | Cite as

Fentanyl or Tramadol, with Midazolam, for Outpatient Colonoscopy: Analgesia, Sedation, and Safety

  • Irina Hirsh
  • Alexander Vaissler
  • Josef Chernin
  • Ori Segol
  • Reuven Pizov
Original Article


The present study determined the acceptability of colonoscopy in outpatients treated with tramadol or fentanyl for analgesia and sedation. One hundred fifty patients were randomly assigned to receive midazolam, 0.05 mg/kg, and fentanyl, 2 μg/kg, intravenously (group 1), midazolam, 0.05 mg/kg, and tramadol, 1 mg/kg, per os (group 2), or midazolam, 0.05 mg/kg, and tramadol, 2 mg/kg, per os (group 3). Pain severity, level of sedation, cardiorespiratory parameters, and procedure-related side effects and complications were registered and analyzed. No significant cardiorespiratory disturbances were observed. Sedation level during the procedure was similar in all groups. Pain severity values measured during the procedure was significantly higher in groups 2 and 3 than in group 1 (P < 0.001). Both hospital and home adverse events occurred more frequently in groups 2 and 3 compared to group 1 (P < 0.03). The patients receiving fentanyl-based analgesia tolerated colonoscopy better than patients treated with tramadol.


Gastrointestinal endoscopy Ambulatory analgesia Sedation Fentanyl Tramadol 



This work was supported by the Lady Davis Carmel Medical Center and the Center for Absorption in Science, Israeli Ministry of Immigrant Absorption. The authors are grateful to Ofra Barnett, Ph.D., and Ada Tamir, Ph.D., D.Sc. for statistical assistance, and to Mark Hirsh, M.D., Ph.D., for his help in preparing the manuscript.


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Copyright information

© Springer Science &#x002B; Business Media, Inc. 2006

Authors and Affiliations

  • Irina Hirsh
    • 1
    • 3
  • Alexander Vaissler
    • 2
  • Josef Chernin
    • 1
  • Ori Segol
    • 2
  • Reuven Pizov
    • 1
  1. 1.Department of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center, and The B. & R. Rappaport Faculty of MedicineTechnion—Israel Institute of TechnologyHaifaIsrael
  2. 2.Department of Gastroenterology, Lady Davis Carmel Medical Center, and The B. & R. Rappaport Faculty of MedicineTechnion—Israel Institute of TechnologyHaifaIsrael
  3. 3.Department of Anesthesiology and Critical Care MedicineLady Davis Carmel Medical CenterHaifaIsrael

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