[Pain in connection with colonoscopy in Norway]
Øyvind Holme1, Volker Moritz, Michael Bretthauer
1Medisinsk avdeling, Sørlandet sykehus, Kristiansand, Norway. oyvind.holme@sshf.no
Summary
Many patients undergoing colonoscopies in Norway experience moderate to severe pain. Pain management practices vary significantly across hospitals, with inadequate use of analgesics and sedatives, suggesting a need for improved pain relief strategies during these common procedures.
Area of Science:
- Gastroenterology
- Pain Management
- Public Health
Context:
- Colonoscopies are a frequent diagnostic procedure in Norwegian hospitals.
- Unlike many countries, routine sedation or analgesia is not standard practice in Norway.
- This study investigates the adequacy of pain relief during Norwegian colonoscopies.
Purpose:
- To assess patient-reported pain levels during colonoscopies in Norway.
- To evaluate the variation in pain management practices across different Norwegian hospitals.
- To determine the effectiveness of current pain relief strategies, including the use of sedatives and analgesics.
Summary:
- Analysis of 61,749 colonoscopies revealed that 33% of patients experienced moderate to severe pain, with higher rates in women (41%) compared to men (24%).
- Significant inter-hospital variability was observed in reported pain levels (9%-43%) and the use of sedatives/analgesics (1%-92%).
- Only 23% of patients reporting pain received analgesics, predominantly pethidine, an opiate with a slow onset of action.
Impact:
- Highlights a significant unmet need for effective pain management in a substantial patient population undergoing colonoscopies in Norway.
- Identifies considerable disparities in clinical practice regarding sedation and analgesia use among Norwegian hospitals.
- Suggests a need to reconsider the choice of analgesics, potentially replacing pethidine with faster-acting alternatives to improve patient comfort and procedural experience.
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