title: Options for screening colonoscopy without sedation: sequel to a pilot study in U.S. veterans.
abstract: 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.
authors.affiliation: 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.
authors.forename: Felix W
authors.initials: FW
authors.lastname: Leung
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Mann
authors.forename: Rodelei
authors.initials: R
authors.lastname: Salera
authors.forename: Lee
authors.initials: L
authors.lastname: Toomsen
authors.forename: Hazel
authors.initials: H
authors.lastname: Cabrera
authors.forename: Dannie
authors.initials: D
authors.lastname: Prather
authors.forename: Rebeck
authors.initials: R
authors.lastname: Gutierrez
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Leung
mesh_terms: 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*