Authors: LEUNG, J. W.; MANN, S.¹; LEUNG, F. W.²

Source: Alimentary Pharmacology & Therapeutics, Volume 26, Number 4, August 2007 , pp. 627-631(5)

Publisher: Wiley-Blackwell

Abstract:

Summary Background 

The direct and indirect costs of sedation limit access to screening colonoscopy amongst United States veterans. Aim 

To determine if offering the option of sedation on-demand reduces the need for sedation. Design 

A retrospective review of prospectively collected performance improvement data in an open access screening colonoscopy programme. Setting 

Performance improvement programme to minimize the burden of sedation at a single VA Medical Center. Subjects 

44 consecutive veterans who accepted the option of sedation on-demand. They could choose to have premedications before the start of colonoscopy, or to begin colonoscopy without premedications and receive the medications upon their request during the examination. Method 

Two experienced endoscopists assisted by experienced nurse assistants performed all of the examinations. Insertion of the colonoscope was aided by infusion of warm water through the colonoscope without air insufflation. Medications were administered at the veterans' request. Results 

Offering the option of sedation on-demand to 44 consecutive veterans permitted 52% (N = 23) of the veterans to complete screening colonoscopy without any sedation. Conclusions 

This novel approach of sedation on-demand and water infusion for screening colonoscopy deserves to be further evaluated in a randomized-controlled study amongst patients undergoing colorectal cancer screening.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2036.2007.03404.x

Affiliations: 1: Section of Gastroenterology, Sacramento VA Medical Center, Veteran Affairs Northern California Health Care System 2: 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 UCLA, USA

Publication date: 2007-08-01

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• By this author: LEUNG, J. W. ;  MANN, S. ;  LEUNG, F. W.

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