| Unsedated colonoscopy: an option for some but not for all. | |
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MedLine Citation:
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PMID: 22248607 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The increasing request for colonoscopy in clinical practice, coupled with the lack of time, has led to a renewed interest in unsedated procedures. OBJECTIVE: To evaluate the acceptability of unsedated colonoscopy and to characterize the subset of patients more likely to undergo and complete the procedure without sedation and/or analgesia. DESIGN: Prospective, population study. SETTING: Nonacademic community hospital, 6-month observation period. PATIENTS: Adult outpatients referred for colonoscopy were offered unsedated procedure, with the possibility of on-demand sedation. INTERVENTIONS: Demographics, clinical features, and endoscopy outcomes were recorded. Data were analyzed by stepwise logistic regression analysis, and odds ratio (OR) and 95% confidence interval (CI) are given for significant variables. MAIN OUTCOME MEASUREMENTS: Unsedated colonoscopy acceptance rate. Factors significantly associated with acceptance and completion of unsedated procedures. RESULTS: The acceptance rate for unsedated colonoscopy was 56.2% of 964 consecutive evaluated patients. The cecal intubation rate in unsedated patients was 81.6% and increased to 97.3% with the option of on-demand sedation. At multivariate analysis, factors significantly associated with the acceptance were no previous colonoscopy (OR 1.52; 95% CI, 1.10-2.11), absent/low level of anxiety (OR 3.82; 95% CI, 2.71-5.38), and no concern about the examination (OR 1.80; 95% CI, 1.17-2.77). Fear of procedure-related pain was inversely associated with acceptance (OR 0.28; 95% CI, 0.17-0.35). Factors associated to drug-free colonoscopy completion were absence of preprocedure anxiety (OR 1.87; 95% CI, 1.08-3.21) and male sex (OR 3.59; 95% CI, 2.13-6.05). LIMITATIONS: Single-center study. CONCLUSION: The acceptance rate of unsedated colonoscopy is clinically relevant, and the procedure can be completed without sedation in the majority of patients. Subject-related factors may help to identify patients willing to undergo and potentially complete unsedated procedures. |
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Authors:
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Silvia Paggi; Franco Radaelli; Arnaldo Amato; Gianmichele Meucci; Giancarlo Spinzi; Emanuele Rondonotti; Vittorio Terruzzi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 75 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-17 Completed Date: 2012-05-25 Revised Date: 2012-10-12 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 392-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Gastroenterology Unit, Valduce Hospital, Como, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anxiety / psychology Colonoscopy / methods*, psychology Confidence Intervals Deep Sedation* Fear / psychology Female Humans Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Patient Acceptance of Health Care / psychology, statistics & numerical data* Patient Satisfaction / statistics & numerical data* Prospective Studies Sex Factors |
| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2012 Sep;76(3):699; author reply 699
[PMID:
22898428
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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