Anesthesia for diagnostic and therapeutic colonoscopy. Results of nine years' work

Abstract

Introduction: colonoscopy is the endoscopic examination of the large intestine. It is a painful, unpleasant procedure generally carried out on an outpatient basis.
Objectives: identify the complications caused by general intravenous anesthesia in diagnostic or therapeutic colonoscopies and determine the degree of patient satisfaction.
Methods: a cross-sectional prospective longitudinal study was conducted of a series of patients scheduled for elective outpatient diagnostic/therapeutic colonoscopy at the National Center for Minimal Access Surgery in a period of nine years. All patients were sedated with midazolam at a dose of 0.01 mg/kg and 0.5 mg atropine sulfate intravenously. General intravenous anesthesia was used which consisted of 2 to 2.5 mg/kg^-1 propofol and 50 µg fentanyl. Maintenance was provided with a continuous infusion of propofol. Anesthetic recovery was classified as rapid, intermediate or late based on recovery time. Complications were classified dichotomically as present or absent, and quantification was conducted of their frequency.
Results: 3 854 patients were studied, of whom 3 833 were elective and 21 emergency. 2 984 colonoscopies were diagnostic and 870 therapeutic. Anesthesia was given to 3 854 patients. In 16 cases (0.41 %) it was not administered due the patients' refusal. Recovery was rapid in 99 % of the cases. Only 25.8 % of the patients had complications. Of these 889 were mild and only 2 severe. Slight and transient respiratory depression was the most common complication (22.3 %). Patient satisfaction was high in all cases.
Conclusion: the use of general intravenous anesthesia for colonoscopy ensures patient safety without a rise in morbidity and mortality, and constitutes a painless procedure raising patient satisfaction.