Sedation-Free Colonoscopy Using an Upper Endoscope Is Tolerable and Effective in Patients with Low Body Mass Index: A Prospective Randomized Study

Authors: Park, Chang-Hwan; Lee, Wan-Sik; Joo, Young-Eun; Kim, Hyun-Soo; Choi, Sung-Kyu; Rew, Jong-Sun; Kim, Sei-Jong

Source: The American Journal of Gastroenterology, Volume 101, Number 11, November 2006 , pp. 2504-2510(7)

Publisher: Wiley-Blackwell

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Abstract:

OBJECTIVE: Small-caliber upper endoscopes can be used safely and effectively for sedation-free colonoscopy. The objective of the study is to assess the efficacy of a small-caliber upper endoscope (9.2 mm) comparing with a standard colonoscope (12.2 mm).

METHODS: In a prospective trial, patients undergoing sedation-free colonoscopy were randomly assigned to the upper endoscope (E) or the standard colonoscope (C). Outcome measures included patient self-assessed pain score (4-point scale), endoscopist-assessed pain score (4-point scale), cecal intubation rate, difficult cecal intubation rate (>900 s), number of polyps detected, and complication rates.

RESULTS: A total of 244 patients were entered. Clinical characteristics were not different between the two groups. Cecal intubation was achieved in 91.0% of the patients in each group. The mean patient self-assessed pain score (SD) was significantly lower in the E group compared with the C group: 1.44 (0.81) versus 2.08 (1.10), p < 0.001. The mean endoscopist assessment of patient pain score (SD) was significantly lower in the E group compared with the C group as well: 1.27 (0.67) versus 1.58 (0.90), p= 0.003. In patients with low body mass index (BMI < 22 kg/m²), the cecal intubation rate was significantly higher in the E group (97.7%vs 79.4%, p= 0.026) and the difficult cecal intubation rate was significantly lower in the E group (9.3%vs 32.4%, p= 0.011). There were no significant differences in the number of polyps detected and complication rates between the two groups.

CONCLUSION: A small-caliber upper endoscope is tolerable and effective for sedation-free colonoscopy, especially in patients with low BMI.

(Am J Gastroenterol 2006;101:2504-2510)

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1572-0241.2006.00790.x

Affiliations: 1: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea

Publication date: 2006-11-01