COLONOSCOPY WITHOUT SEDATION - A VIABLE ALTERNATIVE

PURPOSE AND METHODS: Two hundred fifty-eight consecutive nonsedated co lonoscopies were prospectively evaluated over an 18-month period. The cecum was intubated in 250 cases (97 percent). Polypectomies or biopsi es were performed in 77 cases (31 percent). Indications for colonoscop y included history of polyps (32 percent), hematochezia (28 percent), family history of colon cancer (16 percent), prior history of colon ca ncer (9 percent), change in bowel habits (12 percent), abnormal flexib le sigmoidoscopy (6 percent), and inflammatory bowel disease (3 percen t). RESULTS. Sedation was withheld for the following reasons: patient preference (57 percent), medical problems (2 per cent), prior resectio n (16 percent), surgeon preference (6.5 percent), lack of intravenous access (3 percent), and age (1 percent). Three patients (1.5 percent) required sedation to complete the procedure. Procedure-related pain wa s based on a scale from zero to three. One hundred thirty-nine patient s (61 percent) rated their pain as either zero (no pain) or one (mild pain), and 217 percent (8 percent) indicated that they would prefer th eir next colonoscopy to be performed without sedation. One hundred twe lve patients had previously undergone sedated colonoscopy. Ninety-two (92 percent) preferred nonsedated to sedated procedures. Average proce dure time was 13.7 (range, 0.5 to 85) minutes. CONCLUSIONS: Several se ries have studied nonsedated endoscopic upper and lower gastrointestin al evaluations. None, however, have evaluated patient comfort and sati sfaction. In our prospective series of 258 consecutive nonsedated colo noscopies, we found the procedure to be safe, effective, and well acce pted.