A Comparison of Patient Satisfaction with Two Commonly Used Sedation Regimens for Endoscopy

Purpose: The primary aim of this study was to evaluate whether differences exist in patient satisfaction between groups receiving fentanyl/midazolam and those receiving meperidine/midazolam for general endoscopy conscious sedation. Methods: In this prospective study, answers to the 20 question Patient Satisfaction with Sedation Instrument (PSSI) were collected from 198 patients who received either fentanyl/midazolam (N=91) or meperidine/midazolam (N=107) during endoscopy. The total score, sedation delivery subscale score, procedure recall subscale score, sedation side effects subscale score, and global satisfaction subscale score were calculated according to the PSSI guidelines, where higher scores indicate increased satisfaction. Patient characteristics and endoscopy information were compared between fentanyl/midazolam and meperidine/midazolam groups using Fisher's exact test or a Wilcoxon rank sum test. Results: The distribution of patient age, gender, and interventions were relatively similar between fentanyl/midazolam and meperidine/midazolam groups. There were two significant differences in PSSI responses between the two groups. Patients in the meperidine/midazolam group were more often “very satisfied” with the length of time they felt the effects of the sedation (77% vs. 65%, P=0.048). Also, patients in the meperidine/midazolam group responded “very satisfied” more often regarding how they would compare their satisfaction with this experience to their previous experience with endoscopy (86% vs. 71%, P=0.014). In the PSSI subscale scores between the two sedation groups, results were similar except for the sedation delivery subscale score, which was significantly higher in meperidine/midazolam patients compared to fentanyl/midazolam patients (P=0.034). The sedation delivery subscale score incorporated several questions including ease of medication administration and pain associated with delivery. Conclusion: In this prospective study, we utilized the PSSI, which has previously been externally validated, to compare patient satisfaction with sedation between two groups who received commonly administered regimens. We observed that patients were overall satisfied with sedation in both groups. However, there were several questions for which patients who received meperidine/midazolam were more satisfied than patients who received fentanyl/midazolam, where differences either reached statistical significance or trended toward significance.