ABSTRACT
AIM: To study the need for analgesia and sedation before colonoscopy. PATIENTS AND STUDY DESIGN: Fifty consecutive outpatients were randomly assigned to receive meperidine (0.7 mg/kg) or midazolam (0-035 mg/kg) intravenously (n = 25) or to receive no medication (n = 25) before colonoscopy. Oxygen saturation (SaO2) and heart rate were monitored. Mean blood pressure (MBP) was recorded before and after endoscopy. Patients in the group receiving no medication who experienced marked abdominal pain received sedation and analgesia similar to the premedicated group. Twenty-four hours after the procedure, the patients evaluated the degree of abdominal pain experienced during colonoscopy on a scale from 0 to 9. RESULTS: Complete colonoscopy was performed in 92% of the patients. No significant changes in heart rate were registered in either group. However, in the premedicated group mean blood pressure fell significantly (97.6 +/- 2.6 vs. 89.5 +/- 2.7 mmHg) before and after colonoscopy, respectively (p < 0.05). Nine patients experienced clinically relevant oxygen desaturation (SaO2 > 90%). Of these, five were from the premedicated group and four were from the group receiving no medication. In two patients, both from the premedicated group, the decrease in SaO2 was severe (SaO2 < 85%). The degree of abdominal pain was similar in both groups: 3.64_0.47 (premedicated) vs. 3.92 +/- 0.5 (non-medicated). In the non-medicated group, two patients required analgesia and sedation to complete the colonoscopy and 20 (80%) preferred not to receive sedation in future colonoscopies. CONCLUSIONS: Colonoscopy may be well tolerated without systematic administration of sedation and analgesia, which could be administered selectively.
Subject(s)
Abdominal Pain/etiology , Analgesia , Colonoscopy/methods , Conscious Sedation , Abdominal Pain/prevention & control , Adjuvants, Anesthesia , Anesthesia, Intravenous , Female , Heart Rate/drug effects , Humans , Male , Meperidine , Midazolam , Middle Aged , Oxygen/bloodABSTRACT
3 cases of aneurysm of the splenic artery are presented. The incidence of this disease in the general population is not particularly low, however, it is not often diagnosed as it is not symptomatic. 2 of our patients were admitted because of abdominal pain, one of them with acute abdomen and shock and the other had two periods of symptoms with a nonsymptomatic interval between them; both patients had aneurysm resection and splenectomy. The third patient was non-symptomatic and the aneurysm was discovered due to a ring-like calcification. We highlight the value of a contrast CT scan in order to diagnose splenic artery aneurysms.
