The direct and indirect costs of sedation limit access to screening colonoscopy amongst United States veterans.
Dr Leung and colleagues from California, USA determined if offering the option of sedation on-demand reduces the need for sedation.
The research team performed a retrospective review of prospectively collected performance improvement data in an open access screening colonoscopy program.
The purpose of the program was to minimize the burden of sedation at a single Veterans' Affairs Medical Center.
|52% completed screening colonoscopy without any sedation|
|Alimentary Pharmacology & Therapeutics|
The team assessed 44 consecutive veterans who accepted the option of sedation on-demand.
The subjects could choose to have premedications before the start of colonoscopy.
Alternatively, the subjects could begin colonoscopy without premedications, and receive the medications upon their request during the examination.
The team reported that 2 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.
The researchers found that offering the option of sedation on-demand permitted 52% of the veterans to complete screening colonoscopy without any sedation.
Dr Leung's team concluded, "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."