Gastroenterology, University of California Davis Medical Center, Sacramento, USA.
Gastrointest Endosc. 2011 Jan;73(1):103-10. doi: 10.1016/j.gie.2010.09.020.
Sedation for colonoscopy discomfort imposes a recovery-time burden on patients. The water method permitted 52% of patients accepting on-demand sedation to complete colonoscopy without sedation. On-site and at-home recovery times were not reported.
To confirm the beneficial effect of the water method and document the patient recovery-time burden.
Randomized, controlled trial, with single-blinded, intent-to-treat analysis.
Veterans Affairs outpatient endoscopy unit.
This study involved veterans accepting on-demand sedation for screening and surveillance colonoscopy.
Air versus water method for colonoscope insertion.
Proportion of patients completing colonoscopy without sedation, cecal intubation rate, medication requirement, maximum discomfort (0 = none, 10 = severe), procedure-related and patient-related outcomes.
One hundred veterans were randomized to the air (n = 50) or water (n = 50) method. The proportions of patients who could complete colonoscopy without sedation in the water group (78%) and the air group (54%) were significantly different (P = .011, Fisher exact test), but the cecal intubation rate was similar (100% in both groups). Secondary analysis (data as Mean [SD]) shows that the water method produced a reduction in medication requirement: fentanyl, 12.5 (26.8) μg versus 24.0 (30.7) μg; midazolam, 0.5 (1.1) mg versus 0.94 (1.20) mg; maximum discomfort, 2.3 (1.7) versus 4.9 (2.0); recovery time on site, 8.4 (6.8) versus 12.3 (9.4) minutes; and recovery time at home, 4.5 (9.2) versus 10.9 (14.0) hours (P = .049; P = .06; P = .0012; P = .0199; and P = .0048, respectively, t test).
Single Veterans Affairs site, predominantly male population, unblinded examiners.
This randomized, controlled trial confirms the reported beneficial effects of the water method. The combination of the water method with on-demand sedation minimizes the patient recovery-time burden. (
NCT00920751.).
结肠镜检查不适时的镇静会给患者带来恢复时间的负担。水法允许 52%接受按需镇静的患者无需镇静即可完成结肠镜检查。未报告现场和家庭恢复时间。
确认水法的有益效果，并记录患者的恢复时间负担。
随机对照试验，单盲，意向治疗分析。
退伍军人事务部门诊内镜单位。
本研究涉及接受按需镇静进行筛查和监测结肠镜检查的退伍军人。
用于结肠镜插入的空气与水方法。
无需镇静即可完成结肠镜检查的患者比例、盲肠插管率、药物需求、最大不适（0 = 无，10 = 严重）、与程序相关和与患者相关的结果。
100 名退伍军人被随机分配到空气（n = 50）或水（n = 50）组。水组（78%）和空气组（54%）无需镇静即可完成结肠镜检查的患者比例有显著差异（P =.011，Fisher 确切检验），但盲肠插管率相似（两组均为 100%）。二次分析（数据为平均值[标准差]）显示，水法减少了药物需求：芬太尼 12.5（26.8）μg 与 24.0（30.7）μg；咪达唑仑 0.5（1.1）mg 与 0.94（1.20）mg；最大不适 2.3（1.7）与 4.9（2.0）；现场恢复时间 8.4（6.8）与 12.3（9.4）分钟；家庭恢复时间 4.5（9.2）与 10.9（14.0）小时（P =.049；P =.06；P =.0012；P =.0199；P =.0048，分别为 t 检验）。
单一退伍军人事务网站，主要为男性人群，检查者未设盲。
这项随机对照试验证实了水法的报道效果。水法与按需镇静相结合，最大限度地减少了患者的恢复时间负担。（临床研究登记号：NCT00920751。）
