SELECTIVE SEDATION FOR COLONOSCOPY

A study of selective sedation for colonoscopy was conducted in two par ts. All procedures were performed by one experienced colonoscopist. In the first phase, 41 patients received intravenous sedation before col onoscopy and were then prospectively randomized to either a ''not-reve rsed'' group, which did not receive flumazenil before withdrawal of th e colonoscope, or to a ''reversed'' group, which received flumazenil b efore colonoscope withdrawal. None of the 20 patients reversed and 1 o f the 21 patients not reversed experienced pain during the withdrawal phase of colonoscopy. Sixty percent of patients in the reversed group and 10% in the not-reversed group remembered the colonoscopic findings being explained during the procedure. Ninety percent and 81% of patie nts in the reversed and not-reversed groups, respectively, expressed a preference to be awake to watch the withdrawal of the colonoscope. Tn the second phase of this study, 40 patients underwent colonoscopy wit hout prior intravenous sedation. Sedation was given only if pain was e xperienced during the procedure. Thirty percent had no pain at all, 55 % minimal pain, 8% moderate pain, and 3% severe pain. Twenty-three per cent required intravenous sedation, whereas 78% did not receive any se dation. Ninety-three percent were willing to undergo another colonosco py without prior sedation. Only 8% preferred prior intravenous sedatio n before any future colonoscopy.