3401 Colonoscopy with and without sedation and analgesia.

Abstract

Objectives:This is a prospective case-control study to compare colonoscopy with and without sedation and analgesia in terms of: duration of procedure, complications, the ability to complete the procedure, patient s tolerance, and the endoscopist s difficulty of insertion. Methodology :The patients were monitored before, during and after the procedure using an automated non-invasive blood pressure and finger probe pulse oximetry. Patients underwent colonoscopy performed by a single endoscopist using an Olympus videocolonoscope (CF 130). After the procedure, a visual analogue scale was used by the patients to grade tolerance and by the endoscopist to grade difficulty of insertion. Results:A total of 70 patients included in this study, 36 withsedation (Dormicum 1-5 mg)and analgesia,(Demerol 25 mg) (Group I) and 34 withoutsedation and analgesia (Group II). The time to reach the cecum is 10.28 ± 5 min and 10.91 ± 4.2 min (p = NS) in Groups I and 2, respectively. The total procedure time was 13.6 ± 6.4 min vs.14.1 ± 4.6 min ( p = NS) in Groups 1 and 2, respectively. Desaturation occurred in 7 ± 19.44 vs. 7 ± 20.6 patients (p=NS) in Group I and II respectively. Hypotension occurred in more patients in Group 1; 19 ± 52.8 vs. 0 in Group II (p=0.0001). Pain was graded at 3.75 ± 3.5 vs. 4.8 ± 2.1 (p = NS) in Group I and Group II, respectively. Overall difficulty during scope insertion was graded at 3.17 ± 3.21 vs. 4.65 ± 2.12 (p=0.02) in Group 1 and Group 2, respectively. Patient discomfort was graded at 3.53 ± 3.5 vs 4.68 ± 2.23 (p = 0.03), in Group 1 and Group 2 , respectively. Total colonoscopy was achieved in 70 % vs. 20 % (p = NS), in Group 1 and Group 2, respectively.Willingness to repeat the procedure was noted in 28 vs. 16 patients (p = 0.003), in Group I and II, respectively. The endoscopist graded the difficulty of insertion at 6.8 + 1.7 vs. 7.03 + 2.8, (p = NS), in Group I and II, respectively. Conclusion:Patients undergoing colonoscopy with sedation and analgesia experience less discomfort and difficulty during the procedure, are more willing to repeat the procedure but encounter more complications. There is no statistically significant difference between colonoscopies with and without sedation and analgesia in terms of procedure time, ease on the endoscopist, severity of pain experienced by the patient and in the success of completed colonoscopies.