Options for screening colonoscopy without sedation: sequel to a pilot study in U.S. veterans

Area of Science:

• Gastroenterology
• Medical Technology

Background:

• A novel water infusion technique allowed some veterans to complete screening colonoscopy without sedation.
• This study evaluated the feasibility of unsedated colonoscopy using standard air insufflation.

Purpose of the Study:

• To determine the proportion of patients who could complete colonoscopy without sedation using the usual air insufflation technique.
• To assess the feasibility of screening colonoscopy without sedation in U.S. veterans.

Main Methods:

• Retrospective review of prospectively collected data from a Veterans Affairs screening colonoscopy program.
• Ninety-three veterans underwent colonoscopy with either scheduled no sedation or on-demand sedation.
• Standard air insufflation was used during the procedure, with medications administered upon request.

Main Results:

• Twenty-two out of 23 veterans completed scheduled unsedated colonoscopy.
• Fifty-four out of 70 veterans undergoing on-demand sedation completed the procedure without medication.
• Nurses' perceptions supported the credibility of these unsedated options.

Conclusions:

• Screening colonoscopy without sedation, utilizing air insufflation, is a feasible option for U.S. veterans.
• Further research, including randomized controlled trials, is warranted to confirm these findings.
• Evaluating the impact on costs and patient adherence for screening and surveillance colonoscopies is recommended.