Feasibility of colonoscopy without sedation. A retrospective study of 502 procedures - 26/03/08
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Colonoscopy is usually regarded by patients and physicians as a painful and uncomfortable procedure, and is therefore routinely performed under general anaesthesia in France. Recent surveys in public or private French settings showed a rate of colonoscopies under anaesthesia of 93% to 98% [1 et 2]. However, the clinical benefit of anaesthesia for colonoscopy has not been established: the discomfort of colonoscopy without sedation is not higher than the discomfort of barium enema, for which general anaesthesia is never considered [3]. The generalized use of anaesthesia is probably due to the French regulations, which do not allow administration of sedation by the gastroenterologist. For example, in the United Kingdom less than 1% of colonoscopies are performed under general anaesthesia [4]. Lower tract endoscopies are performed in most countries with systematic or as requested conscious sedation, or routinely without sedation in Japan, Finland, Greece, Norway, the Netherlands, or occasionally in other countries [5, 6, 7, 8, 9 et 10]. For these reasons we have developed the practice of colonoscopy without sedation: in our endoscopy unit we offer to our patients the choice between examination under general anaesthesia or without sedation after fair information. At the beginning of our experience we used various premedications, but in the absence of clear usefulness they were progressively abandoned. Thus, we perform currently lower tract endoscopies without premedication or sedation (excepted oral phloroglucynol). We stop the procedure in case of pain or when required by the patient and consider then colonoscopy under general anaesthesia.
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© 2006 Elsevier Masson SAS. Tous droits réservés.
Vol 30 - N° 2
P. 328-329 - février 2006 Retour au numéro
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