Intravenous paracetamol vs. fentanyl for colonoscopy sedation

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Created On: 20/05/2025

This study aimed to evaluate the clinical effectiveness of intravenous paracetamol versus fentanyl during propofol deep sedation for colonoscopy, due to limited data on paracetamol use.

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Key take away

Intravenous paracetamol and propofol sedation are equally successful as fentanyl, offering a safer alternative for patient comfort during colonoscopy procedures.

Background

This study aimed to evaluate the clinical effectiveness of intravenous paracetamol versus fentanyl during propofol deep sedation for colonoscopy, due to limited data on paracetamol use.

Method

A total of 225 patients undergoing colonoscopy were randomly split into two groups. All participants received deep sedation with propofol and were assigned either paracetamol IV (Group P, number of patients, n = 113) or fentanyl IV (Group F, n = 112). Before the procedure, all patients were provided midazolam IV 0.02-0.03 mg/kg as premedication.

Group P received paracetamol 1000 mg administered 15-30 minutes before the procedure, while group F was administered with fentanyl 0.001 mg/kg, both intravenously. All patients were provided with 100% oxygen via a nasal cannula and received titrated intravenous propofol for deep sedation. The primary outcome was colonoscopy success, while secondary outcomes included satisfaction, tolerance, ease, and sedation-related complications.

Result

All colonoscopies were performed without issues, showing no significant differences between the two groups regarding patient demographics, procedure duration, satisfaction of both endoscopists and patients, tolerance, or ease of the procedure. However, during the procedure, Group F experienced a remarkably higher incidence of upper airway obstruction and oxygen desaturation than Group P. Both groups did not report any major complications.