Bolus administration of sedatives during colonoscopy may make more sense than the usual titrated dosing approach, according to a retrospective analysis of patients treated with fentanyl and midazolam at Duke Medical Center. Details of the investigation include the following:

• Titrated administration was performed by nurses on 966 patients while physicians administered bolus doses on 699 patients.
• Sedation time was 6 minutes in the bolus group vs 13 minutes in the titration group.
• Recovery time didn’t differ significantly between the groups.
• Bolus group patients received lower weight-adjusted doses of fentanyl and midazolam and fewer patients in this group experienced hypotension.