title: Warm water infusion during sedated colonoscopy does not decrease amount of sedation medication used.
abstract: BACKGROUND
  Water infusion versus air insufflation during colonoscope insertion has been suggested to reduce patient discomfort and decrease sedation medication requirements. Warm water is thought to further facilitate colonoscopy perhaps by decreasing colon spasm.
  
  
  OBJECTIVE
  To compare the utility of warm (35°-38°C) versus cool (20°-23°C) water infused during colonoscopic insertion by measuring patient sedation medication use and discomfort scores between the warm and cool water groups.
  
  
  METHODS
  Randomized, controlled, double-blinded study.
  
  
  METHODS
  Outpatient endoscopy unit at an academic medical center.
  
  
  METHODS
  A total of 175 adults.
  
  
  METHODS
  Elective outpatient sedated screening colonoscopies.
  
  
  METHODS
  Sedation medication used, pain scores, cecal intubation rate, endoscopy times, satisfaction scores, and patient willingness to repeat procedures.
  
  
  RESULTS
  There was no significant difference in sedation medication requirement during colonoscopy with the use of warm or cool water (fentanyl 83.6 ± 29.0 μg vs 87.6 ± 39.6 μg; P = .45; midazolam 3.3 ± 1.2 mg vs 3.3 ± 1.3 mg; P = .91). There was no significant difference in patient pain scores or satisfaction scores. Cecal intubation rates (100%) were similar. There was no significant difference in cecal intubation times (6 minutes 40 seconds ± 4 minutes 9 seconds vs 7 minutes 49 seconds ± 4 minutes 0 seconds; P = .06) between the warm and cool water groups. All patients were willing to repeat the colonoscopy by using the same method in both groups.
  
  
  CONCLUSIONS
  Limited generalizability to patients undergoing screening sedated colonoscopies with good to excellent bowel preparation.
  
  
  CONCLUSIONS
  Water does not need to be warmed before infusion in patients undergoing sedated colonoscopies.
authors.affiliation: Division of Gastroenterology, Oregon Health & Science University, Portland, Oregon 97239, USA.
authors.forename: Brent Y
authors.initials: BY
authors.lastname: Lee
authors.forename: Ronald
authors.initials: R
authors.lastname: Katon
authors.forename: Daniel
authors.initials: D
authors.lastname: Herzig
authors.forename: M Brian
authors.initials: MB
authors.lastname: Fennerty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003080:Cold Temperature; D003113:Colonoscopy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000627:therapeutic use; D006358:Hot Temperature; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000627:therapeutic use; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D013997:Time Factors; D014867:Water; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D014867:Water; D008874:Midazolam; D005283:Fentanyl