Comparison between sedated and non-sedated colonoscopy out comes at Kurdistan centers

Abstract

Background: The colonoscopy is a popular screening and diagnostic tool for lower intestinal disorders. The colonoscopy is safe procedure, but pain and discomfort are frequently reported.          

Objective: To compare the need for sedation during colonoscopy in relation to patients' characteristics and colonoscopy outcomes in addition to assess the factors related to pain in colonoscopies without sedations.

Methodology: This study was a clinical prospective follow up study implemented in Kurdistan center for Gastroenterology and Hepatology  (KCGH) in Sulaimani city and Hawler Gastroenterology and Hepatology Center (HGHC) Erbil city-Kurdistan region/Iraq during the period of six months  from 1st of January to 30th of June, 2022 on convenient sample of 201 patients undergoing colonoscopy divided into two study groups (100 patients were sedated and 101 patients were not sedated). All enrolled patients in the study were referred for colonoscopy with indications (constipation, bleeding per rectum, abdominal pain, diarrhea,) or screening colonoscopy or surveillance.

Results: The sedation-free colonoscopy was significantly better than sedated colonoscopy in regard to abdominal compression, position changes, cecal and ileal intubation time, patients' satisfaction, endoscopists' satisfaction and time of stay in colonoscopy unit. However, the abdominal pain was high in sedation-free colonoscopy. Factors related to need for sedation in colonoscopy are younger age, female gender, low body mass index, clinical co-morbidity, previous surgery and absence of prior abdominal pain. Male gender and negative history of previous surgery are the common risk factors of high abdominal pain score in sedation-free colonoscopy.

Conclusions: The non-sedated colonoscopy is possible and can be better than sedated one in certain situations without increase in serious complications rates specially perforations, moreover it can be more cost effective and less time-consuming especially in resource scarce areas.