The use of pentazocine, promethazine, and midazolam in colonoscopy in adults at the University of Benin Teaching Hospital

Abstract

Context: Colonoscopy is a valuable armamentarium for the diagnosis of lesions in the colon. Sedation/anaesthesia makes the procedure easier and tolerable in patients with good bowel preparation. Poor tolerability is one of the reasons for incomplete colonoscopy.

Objectives: To share our experience with the use of Pentazocine, Promethazine, and Midazolam during colonoscopy, highlighting, the indication for colonoscopy, the tolerability of the procedure, success rate (Caecal intubation rate), and lesional findings.

Materials and Methods: This is a 2-year descriptive cross-sectional study of patients referred for colonoscopy in the University of Benin Teaching Hospital. All patients received intravenous single-dose Pentazocine, Promethazine, and Midazolam. They were monitored during the procedure. Patients who required additional doses of Midazolam were adjudged to have poorly tolerated the procedure. The patient's demographics, indication for colonoscopy, colonoscopy findings, histology of specimens, and the tolerability of the procedure were entered into a proforma and analyzed.

Results: Over the study period, 129 colonoscopy were performed. The male-to-female ratio was 2:3 The peak age was 65, and the cluster age group was 5th – 8th decade of life. The caecal intubation rate was 97.7%. Bleeding per rectum was the main indication for colonoscopy in 48 patients (37.2%). Colon cancer was found in 20patients (15.5%) at colonoscopy, while haemorrhoids was found in 32 patients (24.8%). In 16 patient (12.4%) there was more than one lesional finding. A hundred and twenty-five patients (97%) tolerated the procedure, while four (3%) poorly tolerated the procedure. Colonoscopy was poorly tolerated in males (3) compared to females (1).

Conclusion: Bleeding per rectum was the main indication in our study with colonoscopy well-tolerated in 97% of study participants with the use of Pentazocine, Promethazine, and Midazolam.

The authors' advocate the use of single-dose Promethazine, Pentazocine, and Midazolam for elective colonoscopy.