Gastroenterology Unit, Valduce Hospital, Como, Italy.
Gastrointest Endosc. 2012 Feb;75(2):392-8. doi: 10.1016/j.gie.2011.09.015.
The increasing request for colonoscopy in clinical practice, coupled with the lack of time, has led to a renewed interest in unsedated procedures.
To evaluate the acceptability of unsedated colonoscopy and to characterize the subset of patients more likely to undergo and complete the procedure without sedation and/or analgesia.
Prospective, population study.
Nonacademic community hospital, 6-month observation period.
Adult outpatients referred for colonoscopy were offered unsedated procedure, with the possibility of on-demand sedation.
Demographics, clinical features, and endoscopy outcomes were recorded. Data were analyzed by stepwise logistic regression analysis, and odds ratio (OR) and 95% confidence interval (CI) are given for significant variables.
Unsedated colonoscopy acceptance rate. Factors significantly associated with acceptance and completion of unsedated procedures.
The acceptance rate for unsedated colonoscopy was 56.2% of 964 consecutive evaluated patients. The cecal intubation rate in unsedated patients was 81.6% and increased to 97.3% with the option of on-demand sedation. At multivariate analysis, factors significantly associated with the acceptance were no previous colonoscopy (OR 1.52; 95% CI, 1.10-2.11), absent/low level of anxiety (OR 3.82; 95% CI, 2.71-5.38), and no concern about the examination (OR 1.80; 95% CI, 1.17-2.77). Fear of procedure-related pain was inversely associated with acceptance (OR 0.28; 95% CI, 0.17-0.35). Factors associated to drug-free colonoscopy completion were absence of preprocedure anxiety (OR 1.87; 95% CI, 1.08-3.21) and male sex (OR 3.59; 95% CI, 2.13-6.05).
Single-center study.
The acceptance rate of unsedated colonoscopy is clinically relevant, and the procedure can be completed without sedation in the majority of patients. Subject-related factors may help to identify patients willing to undergo and potentially complete unsedated procedures.
临床实践中对结肠镜检查的需求不断增加，加上时间有限，这使得人们对非镇静程序重新产生了兴趣。
评估非镇静结肠镜检查的可接受性，并确定更有可能在无镇静和/或镇痛的情况下进行并完成该程序的患者亚组。
前瞻性、人群研究。
非学术性社区医院，观察期 6 个月。
接受结肠镜检查的成年门诊患者被提供非镇静程序，并可按需接受镇静。
记录人口统计学、临床特征和内镜检查结果。通过逐步逻辑回归分析进行数据分析，并给出有统计学意义的变量的比值比（OR）和 95%置信区间（CI）。
非镇静结肠镜检查的接受率。与接受和完成非镇静程序显著相关的因素。
964 例连续评估患者中，非镇静结肠镜检查的接受率为 56.2%。非镇静患者的盲肠插管率为 81.6%，在需要时使用镇静剂后增加到 97.3%。多变量分析显示，与接受非镇静检查显著相关的因素包括：既往无结肠镜检查（OR 1.52；95%CI，1.10-2.11）、焦虑程度低（OR 3.82；95%CI，2.71-5.38）和对检查无顾虑（OR 1.80；95%CI，1.17-2.77）。对与程序相关的疼痛的恐惧与接受程度呈负相关（OR 0.28；95%CI，0.17-0.35）。与无药物结肠镜检查完成相关的因素包括：术前无焦虑（OR 1.87；95%CI，1.08-3.21）和男性（OR 3.59；95%CI，2.13-6.05）。
单中心研究。
非镇静结肠镜检查的接受率具有临床意义，并且大多数患者可以在无镇静的情况下完成该程序。与患者相关的因素可能有助于识别愿意接受并可能完成非镇静程序的患者。
