Leung Felix W, Mann Surinder K, Salera Rodelei, Toomsen Lee, Cabrera Hazel, Prather Dannie, Gutierrez Rebeck, Leung Joseph W
Division of Gastroenterology, Medical and Research Services, Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Gastrointest Endosc. 2008 Apr;67(4):712-7. doi: 10.1016/j.gie.2007.10.028. Epub 2008 Feb 14.
Sedation on demand combined with a novel water infusion technique enabled 23 of 44 veterans to complete screening colonoscopy without sedation.
With use of the usual air insufflation technique, we determined the proportion of patients who could complete colonoscopy without sedation.
Retrospective review of prospectively collected data in a performance improvement project to minimize the burden of sedation.
A Veterans Affairs open access screening colonoscopy program.
Ninety-three consecutive veterans who accepted on-demand sedation or scheduled no sedation.
Usual air insufflation during colonoscope insertion. Medications were administered at the veteran's request.
Twenty-three veterans chose scheduled unsedated colonoscopy; 22 were completed without sedation. Sedation on demand enabled 54 to complete the procedure without medications; 16 requested medications to complete colonoscopy. Nurses' expectations indicated that the choices were credible options.
Options for screening colonoscopy without sedation combined with usual air insufflation are feasible among U.S. veterans. Confirmation by randomized controlled trial and evaluation of the impact on institutional costs and patient adherence to screening and surveillance colonoscopy deserve to be considered.
按需镇静联合一种新型注水技术使44名退伍军人中的23人在未使用镇静剂的情况下完成了结肠镜筛查。
采用常规空气注入技术，我们确定了无需镇静即可完成结肠镜检查的患者比例。
在一项旨在减轻镇静负担的绩效改进项目中，对前瞻性收集的数据进行回顾性分析。
一个退伍军人事务部开放式结肠镜筛查项目。
93名连续接受按需镇静或计划不使用镇静剂的退伍军人。
结肠镜插入过程中采用常规空气注入。根据退伍军人的要求给药。
23名退伍军人选择计划中的无镇静结肠镜检查；22人在未使用镇静剂的情况下完成检查。按需镇静使54人在未用药的情况下完成了检查；16人需要用药才能完成结肠镜检查。护士的预期表明这些选择是可靠的。
在美国退伍军人中，不使用镇静剂结合常规空气注入进行结肠镜筛查是可行的。值得考虑通过随机对照试验进行证实，并评估其对机构成本以及患者接受结肠镜筛查和监测的依从性的影响。
