Impact of a novel water method on scheduled unsedated colonoscopy in U.S. veterans

摘要

Background: Intermittent warm-water infusion in lieu of air insufflation permitted 52% of patients who accepted sedation on demand to complete colonoscopy without sedation.Objective: To test the hypothesis that the water method enhances cecal intubation and increases the proportion of patients who report willingness to repeat a scheduled unsedated colonoscopy.Design: Observational study.Patients: Two consecutive groups of veterans.Interventions: From June 2005 to May 2006, the usual air insufflation method was used to aid coionoscope insertion. From June 2006 to October 2007, the water method was used.Main Outcome Measurements: Cecal intubation; report of willingness to repeat unsedated colonoscopy.Results: Sixty-two and 63 veterans were examined by the air method and the water method, respectively. Intention-to-treat analysis revealed that the cecal intubation rate with the water method (97% [61/63]) was significantly higher than that with the air method (76% [47/62]). The proportion of patients who reported willingness to repeat unsedated colonoscopy was significantly higher with the water method (90% [57/63]) compared with the air method (69% [43/62]).Limitations: Single site, nonrandomized, unblinded, small number of elderly male veterans.Conclusion: The effects of the water method in the group for scheduled unsedated colonoscopy were sufficiently provocative to warrant calling for their confirmation by a randomized controlled trial.