title: [Viability of colonoscopy without analgesia and conscious sedation].
abstract: OBJECTIVE
  To study the need for analgesia and sedation before colonoscopy.
  
  
  METHODS
  Fifty consecutive outpatients were randomly assigned to receive meperidine (0.7 mg/kg) or midazolam (0-035 mg/kg) intravenously (n = 25) or to receive no medication (n = 25) before colonoscopy. Oxygen saturation (SaO2) and heart rate were monitored. Mean blood pressure (MBP) was recorded before and after endoscopy. Patients in the group receiving no medication who experienced marked abdominal pain received sedation and analgesia similar to the premedicated group. Twenty-four hours after the procedure, the patients evaluated the degree of abdominal pain experienced during colonoscopy on a scale from 0 to 9.
  
  
  RESULTS
  Complete colonoscopy was performed in 92% of the patients. No significant changes in heart rate were registered in either group. However, in the premedicated group mean blood pressure fell significantly (97.6 +/- 2.6 vs. 89.5 +/- 2.7 mmHg) before and after colonoscopy, respectively (p < 0.05). Nine patients experienced clinically relevant oxygen desaturation (SaO2 > 90%). Of these, five were from the premedicated group and four were from the group receiving no medication. In two patients, both from the premedicated group, the decrease in SaO2 was severe (SaO2 < 85%). The degree of abdominal pain was similar in both groups: 3.64_0.47 (premedicated) vs. 3.92 +/- 0.5 (non-medicated). In the non-medicated group, two patients required analgesia and sedation to complete the colonoscopy and 20 (80%) preferred not to receive sedation in future colonoscopies.
  
  
  CONCLUSIONS
  Colonoscopy may be well tolerated without systematic administration of sedation and analgesia, which could be administered selectively.
authors: Unidad de Aparato Digestivo, Fundación Hospital Alcorcón, Madrid. GCacho@fhalcorcon.es
authors: G
authors: G
authors: Cacho
authors: C
authors: C
authors: Dueñas
authors: J
authors: J
authors: Pérez de las Vacas
authors: P
authors: P
authors: Robledo
authors: J L
authors: JL
authors: Rosado
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000517:prevention & control; D000759:Adjuvants, Anesthesia; D000698:Analgesia; D000771:Anesthesia, Intravenous; D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008614:Meperidine; D008874:Midazolam; D008875:Middle Aged; D010100:Oxygen / Q000097:blood
chemical_list: D000759:Adjuvants, Anesthesia; D008614:Meperidine; D008874:Midazolam; D010100:Oxygen