Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial

作者全名："Zhu, Xiwen; Chen, Xuehan; Zheng, Xuemei; Lyu, Hongyao; Chen, Jie; Yan, Ai; Liu, Qi; Li, Shiqi; Zhang, Yamei; Wang, Ting; Duan, Guangyou; Huang, He"

作者地址："[Zhu, Xiwen; Chen, Xuehan; Chen, Jie; Yan, Ai; Liu, Qi; Li, Shiqi; Zhang, Yamei; Duan, Guangyou; Huang, He] Chongqing Med Univ, Affiliated Hosp 2, Dept Anesthesiol, Chongqing, Peoples R China; [Zheng, Xuemei; Lyu, Hongyao] Sichuan Univ, West China Sch Publ Hlth, Dept Prevent Med, Chengdu, Sichuan, Peoples R China; [Wang, Ting] Chongqing Med Univ, Affiliated Hosp 2, Dept Psychol, Chongqing, Peoples R China"

通信作者："Duan, GY; Huang, H (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Anesthesiol, Chongqing, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001032731300001

JCR分区：Q1

影响因子：3.4

年份：2023

卷号：9

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：Alfentanil; Propofol; Colonoscopy; Cognitive function

摘要："Purpose: Colonoscopy is often accompanied by short-term postoperative cognitive decline. We aimed to explore whether single-use alfentanil for patients undergoing elective colonoscopy could reduce cognitive impairment at discharge compared with propofol.Patients and methods: 172 adult patients undergoing elective colonoscopy were randomized to receive intravenous propofol at 2 mg/kg (group P) or alfentanil at 10 & mu;g/kg (group A); 40 healthy volunteers were included in the blank group. Cognitive function was considered the primary outcome and was measured using five neuropsychological tests before sedation and discharge. The z-score method was used to determine cognitive dysfunction according to z-score >1.96 in two types of neuropsychological tests. Other outcomes included discharge time, vital signs, associated adverse events during colonoscopy, and the satisfaction level of patients and endoscopic physicians.Results: 164 patients (78 in group A and 86 in group P) completed the study protocol. At discharge, the incidence of cognitive dysfunction in group P was 23% and was significantly lower in the alfentanil group (2.5%), with a relative risk of 0.11 (95% confidence interval: 0.03-0.46, P < 0.001). The incidence of hypotension in group A was lower than that in group P (3.8% vs 22.1%, relative risk = 0.17 [95% confidence interval: 0.05-0.46, P = 0.001]), and the discharge time in group A was shorter than that in group P (5 [3-9] vs 13 [10-18] min, P < 0.001).Conclusion: For patients undergoing colonoscopy, single-use alfentanil causes less damage to postoperative cognitive function, less risk of hypotension, and shorter discharge time than propofol."

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