title: Sedated vs unsedated colonoscopy: a prospective study.
abstract: OBJECTIVE
  To compare sedated to unsedated colonoscopy in terms of duration, pain and the patient's willingness to repeat the procedure.
  
  
  METHODS
  Consecutive patients who underwent colonoscopies over a 2-year period were invited to participate. All patients who were to undergo our endoscopy unit were offered sedation with standard intravenous sedatives and analgesics, or an unsedated colonoscopy was attempted. Demographic details were recorded. The patient anxiety level prior to the procedure, time to reach the cecum, total discharge time, patient and endoscopist pain assessments, satisfaction after the examination and the patient's willingness to return for the same procedure in the future were recorded.
  
  
  RESULTS
  Among the 403 observed patients, more males were observed in the unsedated group (66.2% vs 55.2%, P = 0.04). Additionally, the unsedated group patients were less anxious prior to the procedure (5.1 vs 6.0, P < 0.01). The colonoscopy completion rates were comparable between the 2 groups (85.9% vs 84.2%, P = 0.66). The time to reach the cecum was also comparable (12.2 min vs 11.8 min); however, the total discharge times were shorter in the unsedated group (20.7 min vs 83.0 min, P < 0.01). Moreover, the average patient pain score (3.4 vs 5.7, P < 0.01) was lower in the sedated group, while the satisfaction score (8.8 vs 7.8, P < 0.01) was significantly higher. There was no significant difference, however, between the groups in terms of willingness to repeat the procedure if another was required in the future (83.3% vs 77.3%, P = 0.17).
  
  
  CONCLUSIONS
  Unsedated colonoscopy is feasible in willing patients. The option saves the endoscopy units up to one hour per patient and does not affect the patient willingness to return to the same physician again for additional colonoscopies if a repeated procedure is needed.
authors.affiliation: Abdulrahman M Aljebreen, Majid A Almadi, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Abdulrahman M
authors.initials: AM
authors.lastname: Aljebreen
authors.affiliation: Abdulrahman M Aljebreen, Majid A Almadi, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Majid A
authors.initials: MA
authors.lastname: Almadi
authors.affiliation: Abdulrahman M Aljebreen, Majid A Almadi, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Felix W
authors.initials: FW
authors.lastname: Leung
mesh_terms: D000328:Adult; D003113:Colonoscopy / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D006993:Hypnotics and Sedatives
keywords: Colonoscopy; Endoscopy; Screening; Sedation; Unsedated