Prospective Evaluation of Factors Predicting Difficulty and Pain During Sedation-Free Colonoscopy

Takahashi, Yuuichi; Tanaka, Hideaki; Kinjo, Mitsuyo; Sakumoto, Ken

doi:10.1007/s10350-004-0940-1

Cited by 115 publications

(94 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the patients with constipation had higher anxiety before the procedure (12), there were no differences between the groups during the assessment of all symptoms in our study. Difference in age probably causes differences in post-procedural findings of anxiety (12). There was a significant difference in STAI-S and the thoughts of patients after the procedure in the group informed by video.…”

Section: Discussionmentioning

confidence: 94%

“…These procedures might be painful, disturbing and time-consuming. Anxiety can also negatively impact the procedure success (5,(10)(11)(12). Methods of verbal or written communication used to inform patients are routinely practiced.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is considerably difficult to get patients' feelings under control. There are few studies addressing the kind of information that should be given before endoscopic interventions to ensure procedure quality and optimal patient comfort (6,10,(12)(13)(14)(15). However, in these studies, there are conflicting results on the superiority of visual, verbal or written communication.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of an information video before colonoscopy on patient satisfaction and anxiety

Arabul¹,

Kandemır²,

Çelık³

et al. 2012

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of an information video before colonoscopy on patient satisfaction and anxiety

Arabul¹,

Kandemır²,

Çelık³

et al. 2012

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…[10][11][12] Clinicians and investigators willing to provide the option have coined a number of terms to lessen the negative impact: sedation-free, [13][14][15][16] medication-free 17 and sedationless 18,19 colonoscopy. A comparison of sedated and unsedated colonoscopy is shown in Table 1.…”

mentioning

confidence: 99%

Is there a place for sedationless colonoscopy?

Leung

2011

jig

View full text Add to dashboard Cite

REVIEW REVIEWUnsedated colonoscopy is available on a routine basis in many parts of the world.1 This paper will discuss the components of patient time burden of sedation, 2 tabulate the extent and significance of sedation-related complications 3 and review how various options without routine sedation impact these events in the context of colorectal cancer screening and surveillance. In the end we shall address the question in the title of this manuscript if there is a place for sedationless (unsedated) colonoscopy. Usedated colonoscopy is routinely available in many parts of the world. In the US, only educated professionals appear to be knowledgeable enough to request the unsedated option. Colonoscopists have also been willing to perform unsedated colonoscopy when a patient presents without an escort after undergoing bowel purge preparation. While the actual sideeffects of sedation are minimal, the escort requirement and time burden of sedation are barriers to the uptake of screening colonoscopy in the US. The recent trend of deep sedation with propofol for screening colonoscopy increases the efficiency of the colonoscopists at significant costs (e.g. anesthetist reimbursement). The options of as needed and on demand sedation permit patients to complete colonoscopy without sedation. The latter appears to be potentially less coercive. Nurses with experience in the unsedated options recognize the benefit of the quick turn-around of the examination room and shortened occupancy of the recovery area. Discharge planning can be optimized due to absence of amnesia. Patients completing unsedated colonoscopy have given their endorsement of the options. Pain and discomfort continue to limit the success rate of cecal intubation to about 80%. A recently described water method (warm water infusion in lieu of air insufflation combined with removal of all residual colonic air by suction and residual feces by water exchange) has the potential of decreasing procedural discomfort and enhancing cecal intubation in unsedated colonoscopy. The availability of the novel water method assures colonoscopists that high success rate of cecal intubation can be achieved in the unsedated patients.

show abstract

“…To counter the negative image of unsedated colonoscopy [20][21][22] proponents have coined the following terms to lessen the "negative" impact: sedation-free, [23][24][25][26] sedationless, 27 and medication-free 28 colonoscopy. To emphasize the positive consequence in the setting of CRC screening and surveillance, the term "sedation risk-free" has also been proposed.…”

Section: Rationale For Considering the Unsedated Option In Colorectalmentioning

confidence: 99%

Unsedated Colonoscopy and the Water Method for Minimizing Discomfort in the Unsedated Patients

Leung¹

2011

Intest Res

View full text Add to dashboard Cite

A decade ago, failure of cecal intubation due to pain in ~20% of scheduled unsedated patients in the author's veterans practice prompted the search for a less uncomfortable approach. Methods that minimized discomfort or enhance cecal intubation included use of pediatric, variable stiffness, computer-assisted, 3-dimensional magnetic imaging colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide; use of hypnosis, music, audio distraction, or simply allowing patients to participate in medication administration. In addition, several water-related techniques (as adjuncts to air insufflation) enhanced speed and success of intubation, reduced discomfort but did not appear to alter the amount of medications used. Because of simplicity, the water-related techniques added to turning off of the air pump were evaluated in a series of trial-and-error modifications. The result was the development of a water infusion in lieu of air insufflation method. Subsequent refinements included suction removal of all residual air to minimize angulations at flexures. Water exchange during insertion was used to suspend and removal feces to clear the luminal view while distention of the colonic lumen was minimize. Observational studies followed by randomized controlled trials confirmed the water method (simplified nomenclature) had significant impacts on discomfort both during and after colonoscopy: reduction of medication requirement; attenuation of insertion-related discomfort, enhancement of cecal intubation, decrease of pain after colonoscopy, increase in reported willingness to repeat unsedated colonoscopy in the patients examined without sedation and reduction of recovery time burden in patients accepting the option of sedation on demand. (Intest Res 2011;9:73-84)

show abstract

Prospective Evaluation of Factors Predicting Difficulty and Pain During Sedation-Free Colonoscopy

Abstract: By use of intubation time and patient pain, several patient characteristics were identified that may predict technical difficulty and pain associated with the procedure. These findings have implications for the practice and teaching of colonoscopy.

Cited by 115 publications

References 11 publications

Impact of an information video before colonoscopy on patient satisfaction and anxiety

Impact of an information video before colonoscopy on patient satisfaction and anxiety

Is there a place for sedationless colonoscopy?

Unsedated Colonoscopy and the Water Method for Minimizing Discomfort in the Unsedated Patients

Contact Info

Product

Resources

About