A Comparative Study between Patients Undergoing Colonoscopy With and Without Sedation

Abstract

Objective: To find criteria for selecting appropriate patients for sedated colonoscopies by comparing the characteristicsof patients choosing unsedated or sedated colonoscopy.Method: This is a prospective non randomized controlled trial. The sample included out-patients, who came forcolonoscopies between October 1, 2008 and June 30, 2009 in the Faculty of Medicine Vajira Hospital. Factorsinvolving procedural difficulty were collected and recorded. The sedation was selected according to thepreference of patients after informed consent. The colonoscopy was performed only by two experiencedcolonoscopists. Data of patients who had total colonoscopy (up to cecum) were analyzed.Results: Total of 107 patients undergoing colonoscopy (53 unsedated and 54 sedated group) with no complication.Patients in both groups had no statistical differences according to sex, age, BMI, underlying disease, historyof previous colonoscopy, cleanliness score, average time spent, difficulty and model of the scope used(Olympus or Pentax). In unsedated group, subjects had moderate and severe pain score in 34.0% and 1.9%respectively compared to none in sedated group. Males tended to have lower pain score than females. Patientswith postgraduate education were found more in the sedated group than the unsedated group (58.5 vs. 29.2%,p=0.003). There were more subjects with history of previous abdominal surgery in the unsedated group thanin the sedated group (54.0% vs. 25.5%, p = 0.003). Indications for colonoscopy were statistically differentbetween both groups (p = 0.002). Abnormal findings were found in the sedated group more than in theunsedated group (31.5%: 13.2%, p = 0.023). Sedation was chosen as the next follow-up colonoscopy more inthe sedated group than in the unsedated group (94.4%: 22.0%, p = 0.000).Conclusion: Factor affecting the decision to select sedated colonoscopy were postgraduate education, no history ofprevious abdominal surgery and abnormal symptoms as an indication for colonoscopy. These findings couldlead to criteria for selecting appropriate patients for sedated colonoscopies at Colorectal Unit, Department ofSurgery, Faculty of Medicine Vajira Hospital.