COMPARISON OF DEXMEDETOMIDINE PROPOFOL AND FENTANYL PROPOFOL SEDATION FOR PEDIATRIC COLONOSCOPY: AN OBSERVATIONAL COMPARATIVE STUDY

Background: Colonoscopy is an essential diagnostic and therapeutic procedure in pediatric gastroenterology, requiring effective procedural sedation to ensure patient comfort, procedural success, and safety. Dexmedetomidine has emerged as a promising adjunct to propofol because of its sedative and analgesic properties with minimal respiratory depression. However, comparative evidence between dexmedetomidine–propofol and fentanyl–propofol for pediatric colonoscopy remains limited. Objective: To compare the efficacy and safety of dexmedetomidine–propofol and fentanyl–propofol combinations for monitored anesthesia care in children undergoing elective colonoscopy. Methods: This study included 64 children (2–12 years; ASA physical status I–II) undergoing elective colonoscopy. Thirty-two patients received dexmedetomidine–propofol (Group D) and thirty-two received fentanyl–propofol (Group F). The primary outcome was post-procedural pain assessed using the Visual Analog Scale (VAS). Secondary outcomes included hemodynamic parameters, total propofol consumption, recovery time based on the Modified Aldrete Score, colonoscopist satisfaction, and adverse events. Results: Baseline demographic and procedural characteristics were comparable between the groups. Group D demonstrated significantly lower post-procedural pain scores than Group F (χ² = 7.929, P = 0.019). Mean total propofol consumption was lower in Group D (135.94 ± 46.13 mg) than in Group F (151.25 ± 48.17 mg), although the difference was not statistically significant (P = 0.199). Recovery time was comparable between the groups (18.59 ± 4.04 vs. 20.13 ± 5.05 min; P = 0.185). Hemodynamic parameters and oxygen saturation remained clinically stable throughout the procedure. Colonoscopist satisfaction was similar in both groups (P = 0.193). No clinically significant sedation-related adverse events were observed. Conclusion: Dexmedetomidine–propofol provided superior post-procedural analgesia while maintaining comparable sedation quality, hemodynamic stability, recovery characteristics, and procedural safety compared with fentanyl–propofol. Dexmedetomidine may represent an effective opioid-sparing adjunct for monitored anesthesia care during pediatric colonoscopy.