title: Unsedated colonoscopy: patient characteristics and satisfaction in a community-based endoscopy unit.
abstract: BACKGROUND
  Patients who have a colonoscopy performed in the United States are usually given moderate to deep sedation.
  
  
  OBJECTIVE
  We report our prospective experience with patients willing to have colonoscopy performed without analgesia or sedation.
  
  
  METHODS
  From June 6, 2006, to December 7, 2006, a total of 2091 patients underwent colonoscopy in our ambulatory endoscopy unit and were offered their procedure with sedation or no sedation.
  
  
  METHODS
  Single-center outpatient ambulatory surgery unit.
  
  
  METHODS
  Consecutive patients who had colonoscopy in our outpatient unit, excluding those who had combined-procedure EGD and colonoscopy.
  
  
  METHODS
  Patients who elected to start colonoscopy without medications could request medication at any point during the procedure. Those who requested medication received narcotics or benzodiazepines.
  
  
  METHODS
  Time to cecum, extent of examination, pain level experienced, and willingness to have the procedure with the same, more, or less medication in the future were evaluated.
  
  
  RESULTS
  A total of 578 patients (27.6%) chose to start without sedation; 470 of those (81.1%, 95% CI, 77.9%-89.3%) completed the examination without medication, 353 men (85%, 95% CI, 84.0%-90.5%) and 117 women (67%, 95% CI, 59.6%-73.4%). Cecal intubation was 1501 of 1512 (99.3%, 95% CI, 98.7%-99.6%) for medicated, 467 of 470 (99.4%, 95% CI, 98.1%-99.8%) for unsedated, and 107 of 108 (99.1%, 95% CI, 93.5%-99.5%) for those who were medicated during the procedure. A total of 458 of the 470 unsedated patients (97.4%, 95% CI, 95.6%-98.5%) were satisfied with their comfort level during the procedure and are willing to have their next colonoscopies without sedation.
  
  
  CONCLUSIONS
  The study is not randomized or blinded.
  
  
  CONCLUSIONS
  Colonoscopy without sedation is feasible, effective, and well tolerated in a typical U. S. population.
authors.affiliation: Current affiliations: Sansum Clinic, Santa Barbara, California, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Petrini
authors.forename: James V
authors.initials: JV
authors.lastname: Egan
authors.forename: William V
authors.initials: WV
authors.lastname: Hahn
mesh_terms: D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies