Colonoscopy without sedation.
OBJECTIVE
In Turkey, colonoscopy is a procedure generally performed with intravenous sedation and analgesia. Most of the complications of colonoscopy are related to sedation. The aims of this study were to determine the percentage of patients who could successfully undergo nonsedated colonoscopy without sedation and to assess patient tolerance and acceptance.


METHODS
The study included 120 consecutive patients undergoing colonoscopy by two endoscopists in our endoscopy unit. The procedure routinely began without sedation, which was later given (midazolam and hyoscine butylbromide) only if significant discomfort occurred. Parameters of blood pressure, oxygen saturation and heart rate were measured before and during colonoscopy. After the procedure patients were asked to rate their pain on a four point scale 1=no pain, 2=slight, 3=moderate, 4=severe and they were also asked if they would be willing to undergo colonoscopy again without sedation.


RESULTS
Eighty eight percent of all colonoscopies were completed without sedation. Mean PaO2 was 96.46 in nonsedated patients and 93.90 (significant p<0.05) in sedated patients. No difference was found between blood pressure and pulse rate of nonsedated and sedated patients. The mean pain score was 2.0 for the nonsedated patients and 3.8 (significant p<0.05) for the sedated patients. Eighty eight percent of patients stated that they would be willing to undergo colonoscopy without sedation again.


CONCLUSIONS
In experienced hands, colonoscopy without sedation can be completed successfully in most patients, without any complications and use of extra instrumentation.
Department of Gastroenterology, Ataturk Teaching and Research Hospital, Izmir, Turkey. gyoruk@isbank.net.tr
Gazi
G
Yörük
Kadir
K
Aksöz
Belkis
B
Unsal
Zafer
Z
Buyraç
Tahir
T
Buran
Nafi
N
Yazicioğlu
Cemal
C
Yildiz
Hüseyin Cahit
HC
Yalçin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010358:Patient Participation; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric