Introduction Colonoscopy is a very common procedure however, unsedated colonoscopy remains underused. The use of sedation increases adverse events, prolongs recovery, affects ability to recall information relating to procedure outcome, and can impact on the efficiency of an endoscopy unit.

Methods A retrospective analysis was carried out on patients attending a large teaching hospital for outpatient colonoscopy from September 1st 2009 to December 31st 2010. A proforma was completed with details relating to demographics, seniority of endoscopist, presence of a trainee, reason for referral, sedation use, outcome of procedure, interventions required, subsequent complications and comfort scores.

Results 244 patients had unsedated colonoscopies (68 female and 176 male) with a median age of 60.6 years. These were matched with 244 randomly selected colonoscopies during that time period. The completion rate was 96% in the unsedated group and 91% in the sedated group (p<0.041). The mean comfort score in the unsedated colonoscopy group was 1.93 and 1.79 in the sedated group. Mean procedure time was 23.6 min (sedated) and 22 min (unsedated). There were no immediate complications in the unsedated group. Complications in the sedated group were seen in 5: Vasovagal episode (n=1), repiratory depression (n=2), bleeding post polypectomy (n=1).

Conclusion An increasing number of unsedated colonoscopies are being performed successfully in our unit with high completion rates, shorter procedure time and similar comfort scores between sedated and unsedated groups. A heightened awareness of the availability of unsedated colonoscopy is required-and it should be offered to all suitable patients.

Competing interests None declared.

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