A Prospective Randomized Trial Comparing Divided Dose of Polyethylene Glycol Solution with Stimulant Laxative Plus Low Dose Polyethylene Glycol Solution for Colon Cleansing / 대한소화기내시경학회지

BACKGROUND/AIMS: This study compared the efficacy and patient's tolerance between those given a divided dose of a polyethylene glycol solution (PEG) and those given a stimulant laxative plus a reduced dose of PEG. METHODS: 190 consecutive patients for colon cleasing were randomized into 3 groups. In group A, 2 L of PEG was administered on the evening prior to the colonoscopy followed by 2 L of the same solution on the morning of colonoscopy. In group B, 2 L of PEG was administered in the morning only. In group C, 2 bisacodyl tablets (10 mg) were administered on the evening prior to colonoscopy and 2 L of PEG was administered in the morning. The patients completed a questionnaire to assess their tolerance to the bowel preparation before the colonoscopy. The endoscopists scored the adequacy of the bowel preparation using the Ottawa scale along with their satisfaction with the quality of the procedure. RESULTS: While 4 patients (6.7%) could not completely take the recommended dose in group A, all patients in groups B and C could take the recommended dose (p=0.012). The patients in Group B had a better tolerance and fewer side effects than those in Group A (p=0.01). A higher adequacy of bowel preparation was observed in group A than in group B (p=0.000) and there appeared to be a higher adequacy of bowel preparation in Group C than in Group B (p=0.06). CONCLUSIONS: The 2 L PEG solution only does not appear to be as effective as a bowel cleansing agent for colonoscopy compared with the divided 4 L PEG solution. No statistical difference in the side effects and efficacy was observed between the divided 4 L PEG solution and the combination of bisacodyl 10 mg with 2 L of a PEG solution.

Patient-Controlled Sedation versus Nurse-Administered Sedation with Propofol during Colonoscopy / 대한소화기내시경학회지

BACKGROUND/AIMS: Patient-controlled sedation (PCS) allows the patients to titrate the dosages of sedative drug according to their needs. The objective of this study was to compare the safety and the efficacy of nurse-administered propofol sedation (NAPS) with those of PCS. METHODS: Eighty one patients were randomly assigned to two groups. All patients received meperidine 25 mg and propofol 40 mg as an initial dose for sedation. Patients in PCS group were subsequently infused with propofol 15 mg over 80 seconds through infusion pump whenever they required. Patients in NAPS group were injected with 10~20 mg propofol by nurse with supervision by endoscopist. The dosage of propofol, cardiopulmonary parameters, procedure time, sedation score, pain score, the patients' and endoscopists' satisfaction scores were assessed. RESULTS: With regard to blood pressure, pulse rate and oxygen saturation, serious complications were not observed. Especially, there was no significant difference of mean total dose between two groups (NAPS group and PCS group received 76.7+/-24.7 mg and 82.5+/-26.6 mg respectively). Pain score was higher in woman than in man (p=0.03). CONCLUSIONS: 1.2~1.5 mg/kg of propofol with small dose of opioid during colonoscopy was effective and safe. NAPS was more practical and useful method of sedation than PCS during colonoscopy.