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Colonoscopy: how was it for you? ▸

The short duration of action and rapid recovery with propofol make it attractive for endoscopy while patient controlled analgesia is a well established technique for analgesia. This trial compared nurse administered sedation (NAPS) with patient controlled sedation (PCS) to determine effectiveness, safety, and patient satisfaction. A total of 155 patients undergoing colonoscopy were eligible, of whom 114 entered the trial. Of these, 40 patients (35%) declined to be randomised, the majority (73%) because they did not want responsibility for their own sedation. This group tended to be younger with higher preprocedure anxiety scores. Thirty-six patients were randomised to PCS and 32 to NAPS. Risk factors for an adverse experience were evaluated, including visual analogue scales for anxiety and, afterwards, tolerability, satisfaction, and willingness to undergo the same method of sedation again. Endoscopists also rated technical difficulty and overall procedure satisfaction, and sedation complications were carefully studied. Both PCS and NAPS were well tolerated with no major complications. The control group (those declining randomisation and treated with standard nurse administered propofol) needed higher doses than the other groups and tended to find the procedure more uncomfortable. PCS resulted in a different …

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