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Endoscopy 2001; 33(11): 949-960
DOI: 10.1055/s-2001-17925
DDW Reports 2001
© Georg Thieme Verlag Stuttgart · New York

Colon Tumors and Colonoscopy

P. Bauerfeind
  • Dept. of Internal Medicine, Zurich University Hospital, Zurich, Switzerland
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Publication History

Publication Date:
18 October 2001 (online)

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Sedation and Preparation

Bowel preparation is one of the main reasons for the low acceptance of colonoscopy. Up to 20 % of colonoscopies are repeated earlier than necessary, due to poor bowel preparation [1]. In a meta-analysis, 11 randomized controlled trials comparing sodium phospate (NaP) and polyethylene glycol (PEG) were pooled, including a total of 861 patients. NaP and PEG were rated as tolerable by 84.5 % and 67.6 % of the patients, and the quality of preparation was good in 82.3 % vs. 74.9 %. The authors therefore recommend NaP [2], confirming the findings of a meta-analysis published 2 years ago [3]. An even better alternative might be a recently developed purgative tablet, which showed excellent acceptance and good preparation in an initial study [4]. The fasting hydrogen breath test may allow identification of some patients with bad preparation [5] [6] [7] , but it is doubtful whether this will become a standard method prior to colonoscopy.

Sedation is the other major factor in patient satisfaction and acceptance of colonoscopy. Propofol administered by a gastroenterologist, instead of midazolam/meperidine, is safe and improves patient satisfaction [8] [9] . In the study by Kulling et al. [8], it was found that patient-controlled sedation using propofol and alfentanil resulted in the highest level of patient satisfaction. In both studies, recovery was faster than with midazolam.

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P.  Bauerfeind, M.D.

Dept. of Internal Medicine
Division of Gastroenterology
Zurich University Hospital

Ramistrasse 100
8091 Zurich
Switzerland


Fax: + 41-1-255 45 03

Email: peter.bauerfeind@dim.usz.ch

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