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 co lonoscopy at an urban family practice residency. The outcomes of biops ies and polypectomies performed during the period of the study were al so evaluated. Methods. Data were prospectively collected on 164 consec utive colonoscopies. Seventy-three percent (124/164) of the examinatio ns were training experiences supervised by the first author. The outco mes of examinations of 126 sedated patients were compared with those o f 38 nonsedated patients. Patients were not randomly selected. Results . Examinations of 126 sedated patients were carried out with an 85% re ach-the-cecum rate compared with a 31% reach-the-cecum rate for 38 non sedated patients (P < .05). A higher percentage of examinations done w ithout sedation (16%) were terminated because of pain than were termin ated 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 termin ated because of inadequate bowel preparation. Adenomas were found in 1 1% (14/126) of sedated patients and in 8% (3/38) of nonsedated patient s. Cancer was detected in 4 sedated patients. Conclusion. These findin gs suggest that sedation in colonoscopy is associated with a higher pe rcentage of complete examinations. Also, patients prepared with an ele ctrolyte purge solution tend to have fewer examinations terminated bec ause of inadequate preparation.