Thiis-Evensen E, Hoff G S, Sauar J, Vatn M H
Department of Medicine, Telemark Central Hospital, Skien, Norway.
Gastrointest Endosc. 2000 Nov;52(5):606-10. doi: 10.1067/mge.2000.109804.
The administration of sedative drugs at colonoscopy has its drawbacks such as increases in the rate of complications and cost. Our aim was to study how individuals, drawn from a population registry and invited to undergo screening colonoscopy for colorectal polyps, experienced the procedure without conscious sedation.
Four hundred fifty-one individuals underwent the screening examination (median age 67 years, range 63 to 72). The cecum was intubated in 369 (82%). Fourteen days after the examination, 429 of the attendees received a questionnaire designed to evaluate their tolerance of the procedure.
Four hundred nine participants (95%) replied.Twenty-one (5%) of these individuals found the examination very uncomfortable, 184 (45%) found it moderately uncomfortable, and 204 (50%) did not find it uncomfortable. A larger proportion of women than men, 110 (63%) versus 79 (41%), found the procedure very or moderately uncomfortable (p<0.001). Three hundred sixty-eight (90%) individuals stated that they would undergo repeat colonoscopy in 5 years.
In this screening setting, routine use of conscious sedation did not seem to be necessary, as most participants found the examination to be only moderately uncomfortable or not at all uncomfortable. Colonoscopy without conscious sedation may, however, reduce the rate of intubation of the cecum and increase the risk of missing adenomas and cancers.
在结肠镜检查中使用镇静药物存在诸多弊端，如并发症发生率增加和成本上升。我们的目的是研究从人口登记处选取并受邀接受结肠息肉筛查结肠镜检查的个体，在未进行清醒镇静的情况下对该检查的体验。
451名个体接受了筛查检查（中位年龄67岁，范围63至72岁）。369人（82%）成功插入盲肠。检查后14天，429名参与者收到了一份旨在评估他们对该检查耐受性的问卷。
409名参与者（95%）回复。其中21人（5%）觉得检查非常不舒服，184人（45%）觉得中度不舒服，204人（50%）不觉得不舒服。觉得检查非常或中度不舒服的女性比例高于男性，分别为110人（63%）和79人（41%）（p<0.001）。368人（90%）表示他们会在5年内接受重复结肠镜检查。
在这种筛查环境下，常规使用清醒镇静似乎没有必要，因为大多数参与者觉得检查只是中度不舒服或根本不觉得不舒服。然而，未进行清醒镇静的结肠镜检查可能会降低盲肠插管率，并增加漏诊腺瘤和癌症的风险。
