Background & Purpose: In some countries it is common for colonoscopy to be performed without sedation. In the U.S., however, conscious sedation is almost always given. The advantages of performing colonoscopy without sedation are that it reduces the risk of the procedure, patients remember post-procedure instructions better, and patients may immediately return to their normal daily activities. We sought to determine the attitude of patients in our three practice settings toward undergoing unsedated colonoscopy. University hospital and clinics=UH; university cancer center=CC; VA hospital=VA. Methods: 291 consecutive outpatients undergoing colonoscopy were given a pre- and post-procedure questionnaire (pre-Q & post-Q) assessing their attitude toward undergoing colonoscopy without sedation. Patients were routinely given meperidine and midazolam for their procedures unless they specifically requested that they be done unsedated (6% of patients at UH, 0% at CC, and 1.4% at VA). Results: Only 18% of patients expressed a willingness to try unsedated colonoscopy on their pre-Q: UH 17%, CC 16%, and VA 23%. Willingness increased modestly on the post-Q to 23%: UH 20%, CC 15% and VA 38%. Willingness to try unsedated colonoscopy in the future correlated with VA practice setting (p=0.003), higher education level (p=0.04), and male sex (p<0.001), but not with age. Conclusions: Only about a fifth of patients undergoing colonoscopy in our three practice settings expressed a willingness to try colonoscopy unsedated. Patients at our VA hospital, who were male, and with higher levels of education were more willing to try. Efforts to increase this frequency will likely require much more intense pre-procedural counseling.
|State||Published - Dec 1 1998|