Sedation associated with a more complete colonoscopy.
BACKGROUND: This study examined the effect of sedation on the rate of complete colonoscopic examinations by a family physician performing colonoscopy at an urban family practice residency. The outcomes of biopsies and polypectomies performed during the period of the study were also evaluated. METHODS: Data were prospectively collected on 164 consecutive colonoscopies. Seventy-three percent (124/164) of the examinations were training experiences supervised by the first author. The outcomes of examinations of 126 sedated patients were compared with those of 38 nonsedated patients. Patients were not randomly selected. RESULTS: Examinations of 126 sedated patients were carried out with an 85% reach-the-cecum rate compared with a 31% reach-the-cecum rate for 38 nonsedated patients (P < .05). A higher percentage of examinations done without sedation (16%) were terminated because of pain than were terminated in sedated patients (5%) (P < .05). An electrolyte purge solution was found to be the most effective colonoscopy preparation; only 7% (7/100) of examinations on patients prepared by this method were terminated because of inadequate bowel preparation. Adenomas were found in 11% (14/126) of sedated patients and in 8% (3/38) of nonsedated patients. Cancer was detected in 4 sedated patients. CONCLUSIONS: These findings suggest that sedation in colonoscopy is associated with a higher percentage of complete examinations. Also, patients prepared with an electrolyte purge solution tend to have fewer examinations terminated because of inadequate preparation.