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A MULTI-CENTRE RANDOMISED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL
6
alfentanil, patients need to arrange transportation, because driving after alfentanil injection
is not allowed for 12–24 hours minimum; this can be a large hurdle for implementation
of alfentanil.
24
Patients who receive butylscopolamine bromide during CT colonography
are already advised not to drive just after the procedure as this may affect the ability to
drive. Because of disadvantages such as the inability to drive, the lack of analgesia has been
mentioned as one of the advantages of CT colonography.
46,47
CONCLUSIONS
Tothebestofourknowledge,wearethefirsttostudytheuseofanalgesiaforCTcolonography.
Our study shows that alfentanil provides a clinically relevant reduction in maximum pain in
CT colonography, reduces total procedural pain and burden without detrimental effects on
procedural time, recovery time, and patient safety. Although desaturations were frequently
observed with alfentanil, these were not considered clinically relevant because they were all
short lasting and self-limiting. Therefore, alfentanil may be an option to improve acceptance,
although it may impact the logistics associated CT colonography examinations. Now, that
we know the advantage of alfentanil, it can be weighed against the practical hurdles, side
effects, and costs. Especially for patients with a low pain threshold, a low-dose intravenous
alfentanil bolus may be viable option. Our secondary outcomes such as the total procedural
pain and burden, the effect on procedure time, and recovery time should be confirmed in
for these outcomes appropriately powered studies. Furthermore, additional data on a low-
dose intravenous bolus injection alfentanil during CT colonography is required to further
assess the safety profile.