IMPACT OF SEDATION TYPE ON ENDOSCOPIC DETECTION OF POLYPS AND ADENOMAS: A TERTIARY CARE CENTER EXPERIENCE

Aims Endoscopic detection of polyps and adenomas decreases the incidence and mortality of colorectal cancer. The available data concerning the relationship between the sedation type and adenoma detection rate (ADR) or polyp detection rate (PDR) is inconclusive. The aim of our study was to evaluate the impact of conscious vs. deep (propofol) sedation on the ADR/PDR in diagnostic and screening colonoscopies.

Methods This was a retrospective cohort study. Patients aged 50-75 years old presenting for a first screening or diagnostic colonoscopy were included. Baseline demographic characteristics were collected, as well as PDR and ADR. Endoscopic withdrawal time and quality of bowel preparation rated in a binary fashion were also collected. Two multivariate logistic regression models were used to evaluate the independent predictors of endoscopic detection of polyps and adenomas.

Results 574 patients met our inclusion criteria. Mean age was 59.26±7.21 with 52.4% females and an average BMI of 28.08±4.89. 57.3% underwent screening colonoscopies, and deep sedation was performed in 34.8%. Only 4.7% had bad bowel preparation. PDR was 70% and ADR was 52%.

On bivariate analysis, no significant difference was shown in PDR and ADR between conscious and deep sedation groups. On multivariate analysis for PDR, age and withdrawal time were independent predictors. For ADR, age, female sex, and withdrawal time were independent predictors. Sedation type and the indication did not reach statistical significance in both models.

Table 1

PDR	Age	Adj. OR 1.035	95%CI (1.004, 1.066)	P=0.024
	Withdrawal time	Adj. OR 1.124	95%CI (1.092, 1.157)	P<0.000
ADR	Age	Adj. OR 1.030	95%CI (1.003, 1.056)	P=0.026
	Female sex (compared to male sex)	Adj. OR 0.638	95%CI (0.444, 0.917)	P=0.015
	Withdrawal time	Adj. OR 1.069	95%CI (1.048, 1.09)	P<0.000

Conclusions In screening or diagnostic colonoscopies, the choice of sedation appears to have no impact on PDR or ADR.

Publication History

Article published online:
14 April 2022