Total intravenous versus inhalational anaesthesia for colonoscopy: A prospective study of clinical recovery and psychomotor function

A randomized, prospective study was conducted on 69 patients comparing reco very after two different anaesthetic techniques for ambulatory colonoscopy. Thirty-five patients received an intravenous fentanyl (1 mug/kg), midazola m (0.05 to 0.075 mg/kg) and propofol (10 to 20 mg boluses as required) comb ination. 34 patients received sevoflurane in 67% nitrous oxide. Drug admini stration was titrated to clinical signs. At baseline and 30, 60, 90 and 120 minutes after the procedure patient performance on a comprehensive battery of psychomotor tests was recorded. Emergence times were noted. Depth of se dation was assessed at 5 minute intervals for 30 minutes after the end of t he procedure. Emergence times were faster in the fentanyl/midazolam/propofo l group by 2.2 minutes. A lower sedation score was detected at 20 minutes i n the sevoflurane/nitrous oxide group. Psychomotor impairment was of a grea ter magnitude and more prolonged by 30 to 90 minutes in the fentanyl/midazo lam/propol group. It is concluded that a sevoflurane/nitrous oxide anaesthe tic has a suitable recovery profile for ambulatory colonoscopy and results in faster recovery of cognitive function compared with a fentanyl, midazola m and propofol combination.