A survey of patient understanding and expectations of sedation/anaesthesia for colonoscopy

One hundred and fifty-nine adult patients undergoing elective colonoscopy in a major regional hospital were surveyed regarding their perceptions and expectations of sedation/anaesthesia for this procedure. The survey was undertaken on the day of the procedure, but before their assessment by the anaesthetist. Most of our patients expected to be completely unconscious and few understood that there was any chance of being aware during any part of their colonoscopy procedure. The perception (level of knowledge) of patients about their sedation/anaesthesia was highly variable, and was influenced both by having had a prior colonoscopy and by having had a discussion with an anaesthetist prior to the day of procedure. Of a range of potential adverse outcomes, procedural awareness generated the highest level of concern. However, those patients who recognised the potential for procedural awareness reported significantly less concern about this potential occurrence than patients who were unaware of the possibility. Our findings suggest that explicit discussion of the possibility of procedural awareness during colonoscopy should be considered by clinicians who administer sedation or anaesthesia for colonoscopy. Knowledge of this potential source of patient confusion and anxiety may enable clinicians to better target the pre-procedural discussion, in order to more appropriately inform patient expectations.