Yi Lu1, Li-Xiao Hao2, Lu Chen1, Zheng Jin1, Biao Gong1. 1. Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 20025, People's Republic of China. 2. Department of Hepatobiliary Surgery, Chinese PLA The 455st Hospital Shanghai 200052, People's Republic of China.
Abstract
BACKGROUND: Patient-controlled sedation (PCS) has been suggested as an alternative method for sedative colonoscopy. However, as any new techniques, PCS introduction as a potential alternative to traditional intravenous sedation (IVS) has brought about challenges. To evaluate the advantages and disadvantages between PCS and IVS more comprehensively, we conducted a systematic review and meta-analysis of the published literature. METHODS: Several databases were searched from inception to 1 April, 2015, for trials comparing PCS with IVS for colonoscopy. The outcomes of interest included time for cecal intubation, rate of complete colonoscopy, dose of sedative drugs used, pain scores, recovery time, complications. Inconsistency was quantified using I (2) statistics. RESULTS: In all, 12 trials were finally selected (1091 patients, with 545 in the PCS group, and 546 in the IVS group). The total propofol used, time for cecal intubation, rate of complete colonoscopy and pain score had no statistical difference between the two groups. However, PCS showed a reduction in the recovery time, incidence of oxygen desaturation and hypotension. The rates of other complications and patients' willingness to repeat the same sedation had no statistical difference between the two groups. CONCLUSION: PCS is as feasible and effective as traditional IVS for colonoscopy, and there is a tendency that PCS shows its superiority in recovery time, incidence for oxygen saturation and hypotension.
BACKGROUND:Patient-controlled sedation (PCS) has been suggested as an alternative method for sedative colonoscopy. However, as any new techniques, PCS introduction as a potential alternative to traditional intravenous sedation (IVS) has brought about challenges. To evaluate the advantages and disadvantages between PCS and IVS more comprehensively, we conducted a systematic review and meta-analysis of the published literature. METHODS: Several databases were searched from inception to 1 April, 2015, for trials comparing PCS with IVS for colonoscopy. The outcomes of interest included time for cecal intubation, rate of complete colonoscopy, dose of sedative drugs used, pain scores, recovery time, complications. Inconsistency was quantified using I (2) statistics. RESULTS: In all, 12 trials were finally selected (1091 patients, with 545 in the PCS group, and 546 in the IVS group). The total propofol used, time for cecal intubation, rate of complete colonoscopy and pain score had no statistical difference between the two groups. However, PCS showed a reduction in the recovery time, incidence of oxygen desaturation and hypotension. The rates of other complications and patients' willingness to repeat the same sedation had no statistical difference between the two groups. CONCLUSION:PCS is as feasible and effective as traditional IVS for colonoscopy, and there is a tendency that PCS shows its superiority in recovery time, incidence for oxygen saturation and hypotension.
Authors: Maxim Mazanikov; Marianne Udd; Leena Kylänpää; Outi Lindström; Pekka Aho; Jorma Halttunen; Martti Färkkilä; Reino Pöyhiä Journal: Gastrointest Endosc Date: 2011-02 Impact factor: 9.427
Authors: Jeff E Mandel; Gary R Lichtenstein; David C Metz; Gregory G Ginsberg; Michael L Kochman Journal: Gastrointest Endosc Date: 2010-05-20 Impact factor: 9.427