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A pilot study to assess feasibility of the water method to aid colonoscope insertion in community settings in the United States

2012; Volume: 2; Issue: 1 Linguagem: Inglês

10.4161/jig.20130

2154-1299

Donald J. Portocarrero, Kendrick Che, Snorri Ólafsson, Michael H. Walter, Christian S. Jackson, Felix W. Leung, Ariel Malamud,

Medical Device Sterilization and Disinfection

Background:The water method decreases patient discomfort and sedation requirement.applicability in non-veteran community settings in the United states (U.s.) has not been reported.Aims: Our aim is to perform a pilot study to establish feasibility of use the water method at 2 community sites.We tested the hypothesis that compared with air insufflation patients examined with the water method would require less sedation without adverse impact on outcomes.Methods: Two performance improvement projects were carried out.consecutive patients who consented to respond to a questionnaire after colonoscopy were enrolled.project 1: The design was single-blinded (patient only); quasirandomized -odd days (water), even days (air).colonoscopy was performed by a staff attending.project 2: a supervised trainee performed the reported procedures.In both, patient demographics (age, gender and body mass index), amount of sedation required during colonoscopy and procedure-related variables were recorded.The patients completed a questionnaire that enquired about discomfort during colonoscopy and willingness to repeat the procedure within 24 hours after the procedure.Results: project 1: significantly lower doses of fentanyl and midazolam were used and a higher adenoma detection rate (aDR) was demonstrated in the water group.project 2: 100% cecal intubation rate was achieved by the supervised trainee.Conclusion: This is the first pilot report in the U.s. documenting feasibility of the water method as the principal modality to aid colonoscope insertion in both male and female community patients.In a head-to-head comparison, significant reduction of sedation requirement is confirmed as hypothesized.No adverse impact on outcomes was noted.