Colonoscopy sedation method has no impact on adenoma detection
Using deep sedation for index average-risk screening colonoscopy procedures did not improve polyp or adenoma detection rates over using moderate sedation, according to study results.
Matthew L. Bechtold, MD, FASGE, of the department of gastroenterology and hepatology at University of Missouri Health Sciences Center, and colleagues wanted to explore whether one technique was more efficient over the other. While moderate sedation saves on costs, deep sedation saves on time.
“You usually have 30 minutes to do a colonoscopy,” Bechtold said in a press release. “When you sedate with moderate sedation techniques, it takes up to twenty minutes to sedate the patient. Deep sedation with Propofol takes about 15 seconds. Is the time better spent looking at a patient's colon or waiting for them to become sedated? That's why we thought maybe the deep sedation would yield a better detection rate.”
Researchers performed a single-center, retrospective study comprising 585 healthy individuals who underwent index screening colonoscopy. They analyzed demographic and polyp data from two groups; the first underwent moderate sedation only (57.7%) and the other underwent only deep sedation (42.2%).
Investigators found that adenoma detection rate was not significantly different between the two groups (44.1% vs. 38.5%). Poly detection rate was also not significantly different between the two groups.
For Bechtold and colleagues at the University of Missouri, their choice to go with deep sedation comes down to time and patient experience.
“If we found a significant improvement in detection with moderate sedation compared to deep sedation, then we may consider going back to moderate sedation,” Bechtold said. “But since we didn't really find a difference, I think the efficiency factor of deep sedation wins out.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.