Effect of propofol anesthesia on force application during colonoscopy.
BACKGROUND
Sedation is frequently used during colonoscopy to control patient discomfort and pain. Propofol is associated with a deeper level of sedation than is a combination of a narcotic and sedative hypnotic and, therefore, may be associated with an increase in force applied to the colonoscope to advance and withdraw the instrument.


OBJECTIVE
To compare force application to the colonoscope insertion tube during propofol anesthesia and moderate sedation.


METHODS
An observational cohort study of 13 expert and 12 trainee endoscopists performing colonoscopy in 114 patients. Forces were measured by using the colonoscopy force monitor, which is a wireless, handheld device that attaches to the insertion tube of the colonoscope.


METHODS
Community ambulatory surgery center and academic gastroenterology training programs.


METHODS
Patients undergoing routine screening or diagnostic colonoscopy with complete segment force recordings.


METHODS
Axial and radial forces and examination time.


RESULTS
Axial and radial forces increase and examination time decreases significantly when propofol is used as the method of anesthesia.


CONCLUSIONS
Small study, observational design, nonrandomized distribution of sedation type and experience level, different instrument type and effect of prototype device on insertion tube manipulation.


CONCLUSIONS
Propofol sedation is associated with a decrease in examination time and an increase in axial and radial forces used to advance the colonoscope.
Chevy Chase Clinical Research, Chevy Chase, Maryland, USA.
Louis Y
LY
Korman
Division of Gastroenterology, Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA.
Nadim G
NG
Haddad
Division of Gastroenterology, Hospital University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
David C
DC
Metz
Division of Gastroenterology, Montefiore Medical Center, Albert Einstein School of Medicine, Bronx, New York, USA.
Lawrence J
LJ
Brandt
Division of Gastroenterology, Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA.
Stanley B
SB
Benjamin
Gastroenterology Division, Department of Veterans Affairs Medical Center, Washington, DC, USA.
Susan K
SK
Lazerow
Gastroenterology Division, Department of Veterans Affairs Medical Center, Washington, DC, USA.
Hannah L
HL
Miller
Department of Biostatistics and Bioinformatics, MedStar Health Research Institute, Washington, DC, USA.
Mihriye
M
Mete
Artann Laboratories, Trenton, New Jersey, USA.
Milind
M
Patel
Artann Laboratories, Trenton, New Jersey, USA.
Vladimir
V
Egorov
D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D015331:Cohort Studies; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D054810:Deep Sedation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D008875:Middle Aged; D015742:Propofol / Q000494:pharmacology*
D018686:Anesthetics, Intravenous; D015742:Propofol