Conscious or Unconscious: the Impact of Sedation Choice on Colon Adenoma Detection

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2011 Oct 26

PMID 22025879

Citations 17

Authors

Mark Metwally

Nicholas Agresti

William B Hale

Victor Ciofoaia

Ryan OConnor

Michael B Wallace

Jonathan Fine

Yun Wang

Seth A Gross

Affiliations

Soon will be listed here.

Abstract

Aim: To determine if anesthesiologist-monitored use of propofol results in improved detection of adenomas when compared with routine conscious sedation.

Methods: This retrospective study was conducted at two separate hospital-based endoscopy units where approximately 12,000 endoscopic procedures are performed annually, with one endoscopy unit exclusively using anesthesiologist-monitored propofol. Three thousand two hundred and fifty-two patients underwent initial screening or surveillance colonoscopies. Our primary end point was the adenoma detection rate, defined as the number of patients in whom at least one adenoma was found, associated with the type of sedation.

Results: Three thousand two hundred and fifty-two outpatient colonoscopies were performed by five selected endoscopists. At least one adenoma was detected in 27.6% of patients (95% CI = 26.0-29.1) with no difference in the detection rate between the anesthesiologist-propofol and group and the gastroenterologist-midazolam/fentanyl group (28.1% vs 27.1%, P = 0.53).

Conclusion: The type of sedation used during colonoscopy does not affect the number of patients in whom adenomatous polyps are detected.

Citing Articles

Association between Colonoscopy Sedation Type and Polyp Detection: A Registry-based Cohort Study.

Quaye A, Hisey W, MacKenzie T, Robinson C, Richard J, Anderson J Anesthesiology. 2024; 140(6):1088-1097.

PMID: 38629957 PMC: 11096037. DOI: 10.1097/ALN.0000000000004955.

Propofol sedation does not improve measures of colonoscopy quality but increase cost - findings from a large population-based cohort study.

Rahman S, Cipriano L, McDonald C, Cocco S, Hindi Z, Chakraborty D EClinicalMedicine. 2024; 70:102503.

PMID: 38495522 PMC: 10940905. DOI: 10.1016/j.eclinm.2024.102503.

Sedation Is Associated with Higher Polyp and Adenoma Detection Rates during Colonoscopy: A Retrospective Cohort Study.

Xu C, Tang D, Xie Y, Ni M, Chen M, Shen Y Gastroenterol Res Pract. 2023; 2023:1172478.

PMID: 36852194 PMC: 9966568. DOI: 10.1155/2023/1172478.

Choice of injection time of conscious sedation and its impact on pain control in colonoscopy.

Su M, Chen T, Zhong Q, Lin D, Liu W, Su Y Front Surg. 2022; 9:886129.

PMID: 36329974 PMC: 9622756. DOI: 10.3389/fsurg.2022.886129.

The Impact of Sedation on Adenoma Detection Rate and Cecal Intubation Rate in Colonoscopy.

Zhang Q, Dong Z, Jiang Y, Zhan T, Wang J, Xu S Gastroenterol Res Pract. 2020; 2020:3089094.

PMID: 33381166 PMC: 7758148. DOI: 10.1155/2020/3089094.

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