Variable Stiffness Colonoscopes Are Associated With Less Pain During Colonoscopy in Unsedated Patients

Yoshikawa, Ichiro; Honda, Hidekazu; Nagata, Kaori; Kanda, Kikuo; Yamasaki, Takuji; Kume, Keiichiro; Tabaru, Akinari; Ōtsuki, Makoto

doi:10.1111/j.1572-0241.2002.07100.x

Cited by 54 publications

(17 citation statements)

References 11 publications

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“…In the sedated patients, the use of a variable-stiffness colonoscope significantly minimized procedure-related pain [14,15], reduced the dose of sedative medications during colonoscopy [15], and shortened cecal intubation time [14]. In the unsedated patients, the variable-stiffness colonoscope allowed favorable examination compared with conventional colonoscope regarding completeness, time to cecal intubation, and comfort of patients undergoing colonoscopy, irrespective of the examiner's experience [6]. The completion rate markedly improved after switching from an adult colonoscope to a small caliber variable-stiffness colonoscope in difficult or incomplete colonoscopies, although the small caliber variable-stiffness colonoscope did not appear to offer any advantage over the adult colonoscope for routine colonoscopies [16].…”

Section: Resultsmentioning

confidence: 97%

“…A recent review of unsedated endoscopy [1] by examining a selection of reports [2][3][4][5][6][7] concluded that the scant amount of literature on unsedated colonoscopy makes the assessment of its feasibility and acceptability difficult. That sedated colonoscopy is usual practice and unsedated colonoscopy has limited acceptance in the United States is confirmed by the result of a recent survey of 18% of the members of the American Society of Gastrointestinal Endoscopy [8].…”

Section: Introductionmentioning

confidence: 98%

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Methods of Reducing Discomfort During Colonoscopy

Leung

2007

Dig Dis Sci

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In the United States sedation for colonoscopy is usual practice. Unsedated colonoscopy is limited to a small proportion of unescorted patients and those with a personal preference for no sedation. Over 80% of patients who accept the option of as-needed sedation can complete colonoscopy without sedation. Colonoscopy in these unsedated patients is performed with techniques similar to those used in the sedated patients. Uncontrolled observations indicate willingness to repeat colonoscopy amongst these patients was correlated significantly with low discomfort score during the examination. Methods reported to minimize patient discomfort or enhance cecal intubation during sedated or unsedated colonoscopy included use of pediatric colonoscope, variable stiffness colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide, hypnosis, music, audio distraction, or simply allowing the patients to participate in administration of the medication. Research focusing on confirming the efficacy of a simple inexpensive nonmedication dependent method for minimizing discomfort will likely improve the outcome of care and more importantly will ensure compliance with future surveillance in patients accepting the unsedated option.

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