Risk Factors for Difficult Sedation-free Colonoscopy / 胃肠病学

ABSTRACT

Background: Colonoscopy has been widely applied in clinic because of its value in screening, diagnosis and treatment of colorectal diseases. Discomfort and pain account for a great part of incomplete intubation during sedation-free colonoscopy. Aims: To identify the predictive factors for difficult sedation-free colonoscopy. Methods: Patients aged 18-80 years old undergone sedation-free colonoscopy at the Tenth People's Hospital of Tongji University from January to December in 2017 were enrolled. The clinical data and medical history were collected. Each patient completed the Eysenck Personality Questionnaire (EPQ) with the help of nurse before colonoscopy. Sedation-free colonoscopy was performed by experienced endoscopist. The Ottawa bowel preparation scale and Visual Analog Scale were used to evaluate the quality of bowel cleansing and pain during the procedure. Results: The total cecum intubation rate was 97.1% (198/204), and 192 patients completing the EPQ were enrolled for analyses. Twenty-four patients had a difficult colonoscopy (intubation time prolonged to >10 min). By univariate analysis, gender, age, body mass index (BMI), history of surgery, pain level and score of Extraversion-Introversion Scale of EPQ (EPQ-E) were associated with difficulty during colonoscopy (all P<0.05). Multivariate analysis revealed that history of pelvic surgery was a risk factor for difficult colonoscopy (OR=6.833, 95% CI 2.396-19.488, P<0.001), whereas overweight (OR=0.190, 95% CI 0.038-0.962, P=0.045) and score of EPQ-E ranged from 8-15 (OR=0.367, 95% CI 0.150-0.896, P=0.028) were protective factors. Conclusions: History of pelvic surgery, lower BMI and extraversion or introversion personality may increase the difficulty during sedation-free colonoscopy. EPQ-E might be used for selecting candidates of sedation-free colonoscopy when it is performed by an inexperienced endoscopist.