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Endoscopy 2010; 42(8): 639-646
DOI: 10.1055/s-0030-1255612
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Patient satisfaction with on-demand sedation for outpatient colonoscopy

B.  Seip1 , M.  Bretthauer2 , S.  Dahler3 , J.  Friestad4 , G.  Huppertz-Hauss1 , O.  Høie5 , E.  Kittang6 , S.  Nyhus6 , J.  Pallenschat5 , P.  Sandvei7 , A.  Stallemo5 , M.  V.  Svendsen8 , G.  Hoff1
  • 1Department of Medicine, Telemark Hospital, Skien, Norway
  • 2Department of Medicine, Rikshospitalet, Oslo, Norway
  • 3Department of Medicine, Blefjell Hospital, Notodden, Norway
  • 4Department of Medicine, Ringerike Hospital, Hønefoss, Norway
  • 5Department of Medicine, Sørlandet Hospital, Kristiansand, Norway
  • 6Department of Medicine, Vestfold hospital, Larvik, Norway
  • 7Department of Medicine, Østfold Hospital, Fredrikstad, Norway
  • 8Department of Research and Development, Telemark Hospital, Skien, Norway
Further Information

Publication History

submitted 15 December 2009

accepted after revision 15 May 2009

Publication Date:
28 July 2010 (online)

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Background and study aim: To reduce the costs of colonoscopy the feasibility of unsedated procedures has been explored. The aims of our study were to assess patient satisfaction with on-demand sedation and identify factors related to painful colonoscopy.

Patients and methods: The Norwegian Gastronet quality assurance documentation tools consist of endoscopy reports (completed on site) and a patient satisfaction questionnaire (completed by the patient on the day after colonoscopy). Data were collected from January 1 2004 to December 31 2006. Colonoscopies reported to be moderately or severely painful were defined as ”painful colonoscopy.”

Results: Nine endoscopy centers representing 86 endoscopists reported 14 915 examinations and 12 354 patient reports were returned (83 % response rate). Patient satisfaction with service and information given was greater than 95 % for all centers. Mean rate of painful colonoscopy was 34 % and mean sedation rate 34 %. Odds ratio (OR) for painful colonoscopy was 2.2 (P < 0.001) when sedation was given. The ORs for painful colonoscopy were similar for all but one center (no. 4) with OR 1.6 (P = 0.04), while the OR for giving sedation was higher for all but one center (no. 1) compared with the reference center (ORs 2.2 to 7.5, all P-values < 0.001).

Conclusion: A surprisingly high rate of painful colonoscopy was found. High sedation rates were not associated with low rates of painful colonoscopy. Recommending increased sedation rates as the only intervention to improve suboptimal performance might not lead to lower rates of painful colonoscopy.

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B. SeipMD 

Vestfold Hospital

PO Box 2168
3103 Toensberg
Norway

Fax: +47-35-005969

Email: bseip@online.no

    The Appendixes are available online: www.thieme-connect.com/media/endoscopy/supmat/en145en.pdfAppendix e1 Endoscopy report form completed by the endoscopist or the endoscopy nurse at the time of colonoscopy: Endoscopist’s form Q2, colonoscopy. Appendix e2 Questionnaire completed by patients the day after colonoscopy: Patient’s form Q1, colonoscopy.