Comparison of remifentanil and fentanyl usage in outpatient endoscopic procedures

Background: Endoscopic procedures in the gastrointestinal tract are associated with patient discomfort and pain, thus requiring analgesia to prevent this. The combination of propofol and fentanyl is frequently used for endoscopic anesthesia. However, in outpatients, the use of analgesia needs to be adjusted by choosing quick-acting analgesia. Remifentanyl has been reported to provide that fast-acting effect but has not been widely compared with other analgesia regimens. This analysis aims to compare the effectiveness of two µ-opioid agonists (fentanyl vs. remifentanyl) for endoscopic procedures. Methods: This Analysis is a randomized, double-blind, controlled trial conducted on patients undergoing endoscopic procedures at RSUP Wahidin Sudirohusodo, Makassar, Indonesia. A total of 38 patients were equally divided into two groups: Group A (receiving remifentanyl + propofol) also Group B (receiving fentanyl + propofol). Onset, recovery, hemodynamic response, and mobilization time were recorded and compared. The data was then analyzed in SPSS version 25 software using independent sample T and Chi-square tests. Results: Onset time, recovery time, also mobilization were faster in Group A than in Group B (p-value = 0.001). This group demonstrated similar mean arterial pressure and lower, more stable heart and respiratory rates compared to the fentanyl and propofol combination in outpatients undergoing lower gastrointestinal endoscopic procedures. Conclusion: Remifentanyl provides faster recovery and mobilization effects compared to fentanyl in the management of outpatients undergoing endoscopic procedures.