title: [Pain in connection with colonoscopy in Norway].
abstract: BACKGROUND
  Colonoscopies are common examinations at Norwegian hospitals. In contrast to many other countries, the majority of colonoscopies in Norway are conducted without routine sedation or analgesia. We wanted to investigate whether current Norwegian practice offers adequate pain relief.
  
  
  METHODS
  The material consists of prospectively recorded outpatient colonoscopies in the period January 2003-December 2011 performed at Norwegian hospitals in the quality assurance network for gastrointestinal endoscopy (Gastronet). We analysed demographic patient data and data from colonoscopies. Patients' experience of pain (none, slight, moderate or severe pain) in connection with the examination was established with the aid of a validated questionnaire.
  
  
  RESULTS
  Data from 61,749 colonoscopies (55% on women) performed at 29 different hospitals were analysed. Colonoscopies were perceived as moderately or very painful by 33% of the patients (41% of the women, 24% of the men, p < 0.001). There were substantial differences between hospitals as to the percentage of colonoscopies that were perceived as moderately or very painful (from 9% to 43%, p < 0.001) and the use of sedatives and analgesics for the colonoscopies (from 1% to 92% of the examinations, p < 0.001). Only 23% of those who found the colonoscopy painful received analgesics. Pethidine was used in 95% of the cases in which analgesics were used during the examination.
  
  
  CONCLUSIONS
  Many patients find colonoscopies painful. Pain relief practice varies substantially between hospitals. Pethidine is an analgesic with a slow onset of action, and should perhaps be replaced with more rapidly acting opiates.
authors.affiliation: Medisinsk avdeling, Sørlandet sykehus, Kristiansand, Norway. oyvind.holme@sshf.no
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Holme
authors.forename: Volker
authors.initials: V
authors.lastname: Moritz
authors.forename: Michael
authors.initials: M
authors.lastname: Bretthauer
authors.forename: Birgitte
authors.initials: B
authors.lastname: Seip
authors.forename: Tom
authors.initials: T
authors.lastname: Glomsaker
authors.forename: Thomas
authors.initials: T
authors.lastname: de Lange
authors.forename: Lars
authors.initials: L
authors.lastname: Aabakken
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Stallemo
authors.forename: Ole
authors.initials: O
authors.lastname: Høie
authors.forename: Stein
authors.initials: S
authors.lastname: Dahler
authors.forename: Per Kristian
authors.initials: PK
authors.lastname: Sandvei
authors.forename: Njaal
authors.initials: N
authors.lastname: Stray
authors.forename: Carl Magnus
authors.initials: CM
authors.lastname: Ystrøm
authors.forename: Geir
authors.initials: G
authors.lastname: Hoff
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D003113:Colonoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use*; D008875:Middle Aged; D009664:Norway; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D008614:Meperidine