Sedation and monitoring practice during colonoscopy varies between centers and over time.
Knowledge of current practice is needed to ensure quality of care and help focus future research.
Dr Froehlich and colleagues from Switzerland examined sedation and monitoring practices in endoscopy centers internationally.
The research team conducted an observational study including 6004 consecutive patients referred for colonoscopy at 21 centers in 11 countries.
Endoscopists reported sedation and monitoring practice, using a standard questionnaire for each patient.
The researchers reported that 53% of patients received conscious/moderate sedation during colonoscopy.
A further 30% received deep sedation, and 17% received no sedation.
The team noted that sedation agents most commonly used were midazolam, and opioids.
Pulse oximetry was done during colonoscopy in 77% of patients, blood pressure monitoring in 34%, and electrocardiography in 24%.
The researchers observed that pulse oximetry was most commonly used for moderately sedated patients.
However, blood pressure monitoring and electrocardiography were used predominantly for deeply sedated patients.
| Sedation and monitoring use ranged from 0% to 100% between centers|
The team found that sedation and monitoring use ranged from 0% to 100% between centers.
Oxygen desaturation occurred in 5% of patients, of whom 80% were moderately sedated.
On average, 3 staff members were involved in procedures.
An anesthesiologist was present during 27% of colonoscopies, and during 85% of colonoscopies using deep sedation.
Dr Froehlich's team concluded, “Internationally, sedation and monitoring practice during colonoscopy varied widely.”
“Moderate sedation was the most common sedation method used and electronic monitoring was used in three-quarters of patients.”
“Deep sedation tended to be more resource-intensive, implying a greater use of staff and monitoring.”