Optimizing depth of sedation for colonoscopy

Excerpt

Colonoscopy is one of the most common investigative procedures performed in contemporary medicine. With the promulgation of national guidelines for the early detection of colorectal cancer,1 it is estimated that millions of colonoscopies are performed worldwide and the demand is likely to grow further each year. Despite the introduction of smaller and more flexible endoscopes, colonoscopy is still associated with significant pain and discomfort. Sedation is therefore generally required for the procedure. Given the large volume of service required, healthcare providers are constantly looking for ways to improve efficiency. In some countries, nurses are trained to administer sedation,2 others have used computer feedback systems to provide sedation during colonoscopy.3,4 Typically, these techniques are limited to provide light sedation that may minimize hemodynamic changes, allow faster emergence, and expedite patient turnover. Nevertheless, patients may become agitated and awake during the procedure, resulting in serious complications. There has yet to be a consensus among endoscopists, anesthesiologists, and patients as to whether deep or light sedation should be provided for colonoscopy. …