Conscious sedation and cardiorespiratory safety during colonoscopy

Ristikankare, Matti; Julkunen, Risto; Mattila, Marco; Laitinen, Tomi; Wang, S.; Heikkinen, Markku; Janatuinen, E; Hartikainen, Juha

doi:10.1067/mge.2000.105982

Cited by 70 publications

(51 citation statements)

References 39 publications

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“…In the majority of patients in Midazolam group, oxygen saturation alterations were observed, though in most cases they resolved spontaneously. Other investigators described similar findings, even after administration of low doses of midazolam [26].…”

Section: Discussionsupporting

confidence: 68%

Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time

et al. 2007

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Section: Discussionsupporting

confidence: 68%

Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time

et al. 2007

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“…A recent review of unsedated endoscopy [1] by examining a selection of reports [2][3][4][5][6][7] concluded that the scant amount of literature on unsedated colonoscopy makes the assessment of its feasibility and acceptability difficult. That sedated colonoscopy is usual practice and unsedated colonoscopy has limited acceptance in the United States is confirmed by the result of a recent survey of 18% of the members of the American Society of Gastrointestinal Endoscopy [8].…”

Section: Introductionmentioning

confidence: 98%

Methods of Reducing Discomfort During Colonoscopy

Leung

2007

Dig Dis Sci

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In the United States sedation for colonoscopy is usual practice. Unsedated colonoscopy is limited to a small proportion of unescorted patients and those with a personal preference for no sedation. Over 80% of patients who accept the option of as-needed sedation can complete colonoscopy without sedation. Colonoscopy in these unsedated patients is performed with techniques similar to those used in the sedated patients. Uncontrolled observations indicate willingness to repeat colonoscopy amongst these patients was correlated significantly with low discomfort score during the examination. Methods reported to minimize patient discomfort or enhance cecal intubation during sedated or unsedated colonoscopy included use of pediatric colonoscope, variable stiffness colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide, hypnosis, music, audio distraction, or simply allowing the patients to participate in administration of the medication. Research focusing on confirming the efficacy of a simple inexpensive nonmedication dependent method for minimizing discomfort will likely improve the outcome of care and more importantly will ensure compliance with future surveillance in patients accepting the unsedated option.

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“…According to previous studies, the frequency of VSF during CS is reported to range from 5 to 20% [17,18,23,24]. However, few studies describe the degree of VSF.…”

Section: Discussionmentioning

confidence: 99%

Risk Factor for Vital Signs Fluctuation during Colonoscopy under Conscious Sedation Consisting of Midazolam and Meperidine

Banno

Kato

Sunata

et al. 2017

Dig Dis

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Background: Sedatives or analgesics are widely used to relieve a patient’s discomfort during colonoscopy (CS). Although cardiopulmonary adverse events are sometimes experienced during the examination, the risk factors for vital signs fluctuation (VSF) have not been fully elucidated. This study thus aimed to identify the risk factors for VSF during the examination, as well as to evaluate the frequency and the degree of VSF. Summary: A total of 755 consecutive subjects who received CS under endoscopist-administrated sedation using midazolam, meperidine, or combination of both were retrospectively analyzed. We assessed the distribution of vital signs during the procedure and frequency of VSF. To identify independent risk factors, we analyzed the association between VSF and subjects’ characteristics and procedure information using the multivariate logistic regression model. Consequently, VSF was observed in 17% of all; hypotension and oxygen desaturation was observed in 13 and 5%, respectively. However, we could achieve the purpose of all procedure and, no one required hospitalization or extension of hospital stay. Multivariate analysis revealed that age (OR 1.05 [95% CI 1.04–1.07]), being female (OR 1.78 [95% CI 1.19–2.70]), and use of midazolam (OR 5.06 [95% CI 3.18–8.08]) were independent risk factors for VSF.

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Conscious sedation and cardiorespiratory safety during colonoscopy

Cited by 70 publications

References 39 publications

Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time

Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time

Methods of Reducing Discomfort During Colonoscopy

Risk Factor for Vital Signs Fluctuation during Colonoscopy under Conscious Sedation Consisting of Midazolam and Meperidine

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