Options for screening colonoscopy without sedation: sequel to a pilot study in U.S. veterans.
BACKGROUND
Sedation on demand combined with a novel water infusion technique enabled 23 of 44 veterans to complete screening colonoscopy without sedation.


OBJECTIVE
With use of the usual air insufflation technique, we determined the proportion of patients who could complete colonoscopy without sedation.


METHODS
Retrospective review of prospectively collected data in a performance improvement project to minimize the burden of sedation.


METHODS
A Veterans Affairs open access screening colonoscopy program.


METHODS
Ninety-three consecutive veterans who accepted on-demand sedation or scheduled no sedation.


METHODS
Usual air insufflation during colonoscope insertion. Medications were administered at the veteran's request.


RESULTS
Twenty-three veterans chose scheduled unsedated colonoscopy; 22 were completed without sedation. Sedation on demand enabled 54 to complete the procedure without medications; 16 requested medications to complete colonoscopy. Nurses' expectations indicated that the choices were credible options.


CONCLUSIONS
Options for screening colonoscopy without sedation combined with usual air insufflation are feasible among U.S. veterans. Confirmation by randomized controlled trial and evaluation of the impact on institutional costs and patient adherence to screening and surveillance colonoscopy deserve to be considered.
Leung
Felix W
FW
Division of Gastroenterology, Medical and Research Services, Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Mann
Surinder K
SK
Salera
Rodelei
R
Toomsen
Lee
L
Cabrera
Hazel
H
Prather
Dannie
D
Gutierrez
Rebeck
R
Leung
Joseph W
JW
D002140:California; D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014728:Veterans / Q000706:statistics & numerical data*