Effect of propofol anesthesia on force application during colonoscopy.
Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: Sedation is frequently used during colonoscopy to control patient discomfort and pain. Propofol is associated with a deeper level of sedation than is a combination of a narcotic and sedative hypnotic and, therefore, may be associated with an increase in force applied to the colonoscope to advance and withdraw the instrument. CONCLUSIONS: Propofol sedation is associated with a decrease in examination time and an increase in axial and radial forces used to advance the colonoscope.Copyright � 2014. Published by Mosby, Inc. DESIGN: An observational cohort study of 13 expert and 12 trainee endoscopists performing colonoscopy in 114 patients. Forces were measured by using the colonoscopy force monitor, which is a wireless, handheld device that attaches to the insertion tube of the colonoscope. LIMITATIONS: Small study, observational design, nonrandomized distribution of sedation type and experience level, different instrument type and effect of prototype device on insertion tube manipulation. MAIN OUTCOME MEASUREMENTS: Axial and radial forces and examination time. OBJECTIVE: To compare force application to the colonoscope insertion tube during propofol anesthesia and moderate sedation. PATIENTS: Patients undergoing routine screening or diagnostic colonoscopy with complete segment force recordings. RESULTS: Axial and radial forces increase and examination time decreases significantly when propofol is used as the method of anesthesia. SETTING: Community ambulatory surgery center and academic gastroenterology training programs.