Topic Highlight
Copyright ©2010 Baishideng.
World J Gastrointest Endosc. Mar 16, 2010; 2(3): 81-89
Published online Mar 16, 2010. doi: 10.4253/wjge.v2.i3.81
Table 2 Worldwide practice of sedation-risk-free colonoscopy
Endoscopist (location) (N)Cecal intubation (%)Special techniqueIncomplete/difficult intubationPredictor(s) of painRef.
GI (Taiwan) (176)97.70ColonoscopyIntolerance (n = 2), technical difficulty (n = 1), poor preparation (n = 1)Female gender and the endoscopist[22]
Surgeon (Taiwan) (109)85.30Previous gynecological surgery[23]
GI (Italy) (510)95.70Oil, warm water vs air[24]
GI (Korea) (426)95.30Older age, lower body mass index (BMI) and previous hysterectomyOlder age, lower BMI, hysterectomy, diarrhea, 1st time colonoscopy and anxiety[25]
GI (Korea) (N = 244) (Low BMI n = 77)97.7 (UE) vs 79.4 (C) (low BMI)Upper endoscope (UE) vs Colonoscope (C)9.3% (UE) vs 32.4% (C) (low BMI)Use of C rather than UE[26]
GI (France) (502)78MusicPain, poor bowel prep[27]
GI (Japan) (848)99.60Lower BMI, female, preparation status, previous hysterectomyLower BMI, younger age, intubation time, preparation status, previous hysterectomy[29]
GI (Japan) (287)96Ultrathin vs pediatric or standard scopelooping in the ultrathin group, angulations or stricture in the pediatric and standard groups[30]
GI (Saudi Arabia) (503)67Incomplete due to inadequate bowel prep (14.3%), due to pain (9.5%)[31]
GI (Turkey) (120)88Mean pain score: 2.0 for the nonsedated and 3.8 for the sedated patients (P < 0.05)[32]
GI (Croatia) (22)2 of 22 patients in whom no sedation was used had oxygen saturation < 90 %[33]
GI (Japan) (259)95-96Water instillation vs air insufflations17.1% (water) and 33.3% (air) had abdominal pain (P < 0.001)[34]
GI (Italy) (124)On demand sedation (66% required sedation)34% reported moderate or severe pain and 22% unwilling to repeat[35]
GI (Norway) (409)82 (90 willing to repeat)Overall cohort: 5% very, 45% moderately, 50% not uncomfortable; 63% women vs 41% men, very or moderately uncomfortable[36]
GI (Greece) (173)92 unsedated, 87.9 successMale gender, segmental colonic resection predict success[37]
GI (Finland) (120)After the procedure: midazolam vs placebo group (30 vs 40 mm; P < 0.05; visual analog scale, 0 to 100 mm: 0 = not at all, 100 = extremely)[38]
GI (Germany) (100)95 (87 willing to repeat)As needed sedation (5%)On a scale of 1 to 9, barium enema and colonoscopy produced similar ratings of discomfort (3.1 vs 3.2)[39]
Surgeons (Singapore) (40)78 (93 willing to repeat)As needed sedation23% required intravenous sedationThirty percent had no pain, 55% minimal pain, 8% moderate pain and 3% severe pain[40]
GI (Japan) (467)98-99Variable stiffness (VSC) vs standard (CC)Lower mean pain score was noted in VSC patients compared with CC patients[45]