Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Acta Med Okayama. 2023 Oct;77(5):471-478. doi: 10.18926/AMO/65969.
Although the clinical usefulness of colonoscopy has been established, the procedure remains painful for many patients. This study was designed to clarify the factors predicting colonoscopy-related pain. We evaluated 283 consecutive patients who completed a first-ever, total colonoscopy without sedatives or analgesics. The severity of pain symptoms was evaluated by a numeric rating scale (NRS) in a questionnaire immediately after the colonoscopy. Patient backgrounds and endoscopic findings were analyzed to evaluate their association with pain. Out of 283 patients, 53 scored their pain 0-1 on the NRS while 48 scored it 6-10. We defined the colonoscopies of the former and latter patients as painless and painful, respectively, and compared the two. Multivariate analyses revealed that low body weight (OR 4.95, 95%CI 1.89-12.99) and longer intubation time (OR 3.63, 95%CI 1.46-9.03) were significant risk factors for painful colonoscopy. To identify factors contributing to the increased intubation time, we divided subjects into short- and long-intubation-time groups based on a median insertion time of 7 min. Older age (OR 2.28, 95%CI 1.31-3.98), previous abdominal surgery (OR 1.93, 95%CI 1.13-3.32) and findings of invasive cancer (OR 10.90, 95%CI 1.34-88.90) were significant factors for longer intubation time.
虽然结肠镜检查的临床实用性已经得到证实，但该过程仍令许多患者感到疼痛。本研究旨在明确预测结肠镜检查相关疼痛的因素。我们评估了 283 例首次接受无镇静或镇痛剂的全结肠镜检查的连续患者。通过问卷在结肠镜检查后立即使用数字评分量表（NRS）评估疼痛症状的严重程度。分析患者背景和内镜发现，以评估其与疼痛的关联。在 283 例患者中，53 例 NRS 评分为 0-1，48 例评分为 6-10。我们将前者和后者的结肠镜检查分别定义为无痛和疼痛，并对两者进行比较。多变量分析显示，低体重（OR 4.95，95%CI 1.89-12.99）和更长的插管时间（OR 3.63，95%CI 1.46-9.03）是结肠镜检查疼痛的显著危险因素。为了确定导致插管时间延长的因素，我们根据 7 分钟的中位插入时间将受试者分为短插管时间组和长插管时间组。年龄较大（OR 2.28，95%CI 1.31-3.98）、既往腹部手术史（OR 1.93，95%CI 1.13-3.32）和侵袭性癌症发现（OR 10.90，95%CI 1.34-88.90）是插管时间延长的显著因素。
