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2015 ; 82
(3
): 503-11
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Practice patterns of sedation for colonoscopy
#MMPMID25851159
Childers RE
; Williams JL
; Sonnenberg A
Gastrointest Endosc
2015[Sep]; 82
(3
): 503-11
PMID25851159
show ga
BACKGROUND: Sedative and analgesic medications have been used routinely for
decades to provide patient comfort, reduce procedure time, and improve
examination quality during colonoscopy. OBJECTIVE: To evaluate trends of sedation
during colonoscopy in the United States. SETTING: Endoscopic data repository of
U.S. gastroenterology practices (Clinical Outcomes Research Initiative, CORI
database from 2000 until 2013). PATIENTS: The study population was made up of
patients undergoing a total of 1,385,436 colonoscopies. INTERVENTIONS:
Colonoscopy without any intervention or with mucosal biopsy, polypectomy, various
means of hemostasis, luminal dilation, stent placement, or ablation. MAIN OUTCOME
MEASUREMENTS: Dose of midazolam, diazepam, fentanyl, meperidine, diphenhydramine,
promethazine, and propofol used for sedation during colonoscopy. RESULTS: During
the past 14 years, midazolam, fentanyl, and propofol have become the most
commonly used sedatives for colonoscopy. Except for benzodiazepines, which were
dosed higher in women than men, equal doses of sedation were given to female and
male patients. White patients were given higher doses than other ethnic groups
undergoing sedation for colonoscopy. Except for histamine-1 receptor antagonists,
all sedative medications were given at lower doses to patients with increasing
age. The dose of sedatives was higher in colonoscopies associated with procedural
interventions or of long duration. LIMITATIONS: Potential for incomplete or
incorrect documentation in the database. CONCLUSION: The findings reflect on
colonoscopy practice in the United States during the last 14 years and provide an
incentive for future research on how sex and ethnicity influence sedation
practices.
|Adenoma/*diagnosis/surgery
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Analgesics, Opioid/*therapeutic use
[MESH]
|Biopsy
[MESH]
|Black or African American
[MESH]
|Catheter Ablation
[MESH]
|Cohort Studies
[MESH]
|Colonic Polyps/*diagnosis/surgery
[MESH]
|Colonoscopy/*methods
[MESH]
|Colorectal Neoplasms/*diagnosis/surgery
[MESH]
|Conscious Sedation/*methods
[MESH]
|Databases, Factual
[MESH]
|Diazepam/therapeutic use
[MESH]
|Dilatation
[MESH]
|Diphenhydramine/therapeutic use
[MESH]
|Early Detection of Cancer
[MESH]
|Female
[MESH]
|Fentanyl/therapeutic use
[MESH]
|Hispanic or Latino
[MESH]
|Humans
[MESH]
|Hypnotics and Sedatives/*therapeutic use
[MESH]
|Linear Models
[MESH]
|Male
[MESH]
|Meperidine/therapeutic use
[MESH]
|Midazolam/therapeutic use
[MESH]
|Middle Aged
[MESH]
|Multivariate Analysis
[MESH]
|Pain Management/*methods
[MESH]
|Practice Patterns, Physicians'/*statistics & numerical data
[MESH]
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free
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