comparison of the analgesic effect of intravenous paracetamol/midazolam and fentanyl in preparation

background: although some patients can tolerate colonoscopy procedure using fentanyl/ midazolam without any sedation and analgesic requirements but some patients may require additional sedation with benzodiazepines. we performed the present study to compare the effect of paracetamol/midazolam with fentanyl/ midazolam. methods: in a clinical trial, 96 patients aged 18 to 75 years old, who were candidate for elective colonoscopy assigned consecutively into two groups as paracetamol/midazolam and fentanyl/midazolam. the first group received 1 gr paracetamol 45 minutes before colonoscopy and 0.5 mg/kg midazolam 5 minutes before colonoscopy whereas the second group received 04- 0.5-1 mcg/kg fentanyl 3 minutes before colonoscopy and similar dose of midazolam. the two groups were compared in regard to patient intensity, discomfort, a colonoscopist and, patient satisfaction and rescue dose of propofol during colonoscopy and vital signs. results: there was no significant difference between the two groups for patient pain score, colonoscopist satisfaction, patient satisfaction and rescue dose of propofol (p=0.817, 0.978, 0.460, and 0.104, respectively). the incidence of apnea was greater in fentanyl group (p=0.045). after adjusting for age and education, there was also no significant difference between the two groups. conclusion: this study indicates that paracetamol can be considered as an alternative drug regimen in preparation of colonoscopy.