Leung Felix W
Research and Medical Services, Sepulveda Ambulatory Care Center, West Los Angeles Veterans Affairs Medical Center, Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda, Los Angeles, CA, USA.
Dig Dis Sci. 2008 Oct;53(10):2719-22. doi: 10.1007/s10620-007-0192-8. Epub 2008 Feb 15.
Nurses for monitoring and recovery are required for sedated colonoscopy. A nursing shortage necessitated discontinuation of sedated colonoscopy at a VA academic training program.
Elements of a case series that documented acceptance of unsedated colonoscopy are reviewed to raise awareness of the feasibility of this option.
The pros and cons of sedation and no sedation were summarized. After discussion, patients who chose the unsedated option were scheduled for examination locally while those who desired sedation were scheduled at another VA site. Colonoscopy was performed by supervised trainees.
From September 2002 to June 2005 scheduled unsedated colonoscopy was accepted by 145 of 483 veterans. Cecal intubation was achieved in 81%. Thus, of the cohort 30% had local access to and 24% completed unsedated colonoscopy. Implementation of unsedated colonoscopy obviated the need for two registered nurses previously required for sedated colonoscopy.
Unsedated colonoscopy offered as an option to ensure access was acceptable to a subgroup of our veteran patients. Implementation required less nursing resources. Techniques to enhance the cecal intubation rate of unsedated colonoscopy performed by supervised trainees deserves to be assessed in future studies.
镇静结肠镜检查需要护士进行监测和协助恢复。由于护理人员短缺，一家退伍军人事务部（VA）学术培训项目不得不停止镇静结肠镜检查。
回顾一系列记录未镇静结肠镜检查接受情况的病例，以提高对该检查可行性的认识。
总结了镇静和不镇静的利弊。经讨论后，选择未镇静检查的患者在当地安排检查，而希望接受镇静的患者则安排在另一家退伍军人事务部机构进行检查。结肠镜检查由接受监督的实习生操作。
从2002年9月至2005年6月，483名退伍军人中有145人接受了预定的未镇静结肠镜检查。盲肠插管成功率为81%。因此，在该队列中，30%的人能够在当地进行检查，24%的人完成了未镇静结肠镜检查。未镇静结肠镜检查的实施不再需要之前镇静结肠镜检查所需的两名注册护士。
对于我们的一部分退伍军人患者，提供未镇静结肠镜检查作为确保检查机会的一种选择是可以接受的。实施该检查所需的护理资源较少。由接受监督的实习生进行的未镇静结肠镜检查提高盲肠插管率的技术值得在未来研究中进行评估。
