Does Propofol Sedation Increase the Cecal Intubation Rate in Colonoscopy?

Tardu, Ali

doi:10.14744/less.2017.64936

Cited by 1 publication

(4 citation statements)

References 12 publications

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“…However, it has been noted in the literature that the CIR varies between 55% and 98.8% [ 4 ]. However, about 5%-10% of colonoscopies conducted by skilled endoscopists fail to intubate the ileum [ 2 ]. In the current study, the adjusted cecal intubation rate was 71.9%, which correlates with the CIR range described by Muslim and Al-Obaidi [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Excessive loop formation and failure to cross angulated, fixed, or strictured sigmoid are two causes of failure. Female patients who have had gynecological surgery in the past and with advanced diverticular disease are most likely to experience procedure failure [ 2 , 10 ]. Age and a greater body mass index (BMI) both enhance the likelihood of reaching the cecum.…”

Section: Discussionmentioning

confidence: 99%

“…Propofol-based deep sedation was started to be utilized recently because it has been demonstrated that propofol has a better pharmacokinetic profile than benzodiazepines and opioids [ 16 ]. In light of the CIR and the absence of complications in any of the subjects, Tardu et al concluded that propofol-based sedation is both secure and efficient [ 2 ]. The analgesia regimen used in our patients consists of 5 mg of nalbuphine along with metoclopramide, and 2 mg of midazolam was administered for pain control and topped up by 1-2 mg as per the needs of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The endoscope might not be able to reach the cecum due to the patient's discomfort during the process. Patients may receive conscious or sound sedation to avoid this scenario [ 2 ]. Sedation techniques vary greatly between countries and regions.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the Safety and Quality of Diagnostic Colonoscopies Performed by General Surgeons: A Retrospective Study

Naeem¹,

Farooq²,

Sadiq³

et al. 2023

Cureus

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Introduction Colonoscopy, which is a challenging procedure and requires adequate time to master the skill, is the procedure of choice to visualize colonic mucosa to rule out many colonic pathologies. There is a dearth of published information from real clinical experiences regarding successful procedures and limitations. The end point of colonoscopy is the visualization of the cecal pole by intubating the cecum. Many Europeans and English health organizations recommend that the procedure should have a completion rate of around or above 90%. Gut preparation is an important determinant for a successful procedure and obviates the need for further invasive and/or expensive procedures such as imaging. The majority of colonoscopies are being performed by gastroenterologists (GI) throughout the world, and the role of a surgeon as an endoscopist is in debate. Before this study, neither a retrospective nor a prospective evaluation of the general surgeon's (GS) endoscopy's quality and safety had been evaluated in our institution. Material and method This retrospective observational study was carried out from 1 January 2022 to 31 August 2022 in the Department of Surgery at Mayo Hospital, Lahore, to evaluate colonoscopy completion rates, reason for failure, and complications in terms of bleeding and perforation. All patients undergoing lower gastrointestinal endoscopy (LGiE), both elective and emergency, were included. Patients under 15 years of age and patients known to be hepatitis B-positive or hepatitis C-positive were excluded from the study. All relevant data were entered into a data sheet. Qualitative variables such as gender, cecal intubation, adjusted cecal intubation, gut preparation, reasons for failed colonoscopy, analgesia use, and complications (bleeding and perforation) were calculated as frequency and percentage. Quantitative data such as age and pain score were reported as mean and standard deviation (SD). Details obtained were tabulated and analyzed via the Statistical Package for Social Sciences (SPSS) version 29.0 (IBM SPSS Statistics, Armonk, NY). Results A total of 57 patient data were collected; 35.1% (n=20) were female, and 64.9% (n=37) were males. The cecal intubation rate (CIR) was 49.1% (n=28), and the adjusted rate was 71.9%, excluding incompleteness due to mass obstructing lumen, 8.8% (n=5); planned left colonoscopy, 7% (n=4); sigmoidoscopy, 3.5% (n=2); distal stoma scope, 1.8% (n=1); and colonic stricture, 1.8% (n=1). The prevalent reason for failed colonoscopy was inadequate gut preparation (15.8% {n=9}). Other reasons include patient discomfort, 3.5% (n=2); looping of scope, 7% (n=4); and acute colonic angulation, 1.8% (n=1). No complications were recorded. Conclusion This study shows that colonoscopy can be done by general surgeons safely and effectively with adequate training. High rates of cecal intubation emerge during colonoscopies performed under deep sedation and by skilled colonosco...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%