Shengbing Zhao1, Xia Yang2, Qianqian Meng1, Shuling Wang1, Jun Fang3, Wei Qian1, Tian Xia1, Peng Pan1, Zhijie Wang1, Lun Gu1, Xin Chang1, Duowu Zou4, Zhaoshen Li1, Yu Bai1. 1. Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China. 2. Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China; Department of Gastroenterology, No. 905 Hospital of The Chinese PLA, Shanghai, China. 3. Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China. 4. Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China; Department of Gastroenterology, Ruijing Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Abstract
BACKGROUND AND AIMS: Colonoscopy insertion is painful for some patients and is one of the main barriers to screening colonoscopy. Few studies have assessed the impact of the supine position (SP) on colonoscopy insertion, especially for unsedated patients. The aim of this randomized controlled trial was to clarify this issue. METHODS:Unsedated patients were randomized to SP or left horizontal position (LHP) as the starting position of colonoscopy insertion. The primary outcome measure was cecal intubation time (CIT), and the secondary outcome measures were descending colon intubation time (DIT), pain score of patients, difficulty score according to the endoscopist, and patients' acceptance of unsedated colonoscopy. RESULTS: A total of 347 patients were randomized to the SP group (175) or the LHP group (172). The CIT in the SP group was significantly shorter than that in the LHP group (275.0 seconds [interquartile range (IQR), 234.0-328.5 seconds] versus 316.0 seconds [IQR, 261.0-370.0 seconds], P < .001). The DIT was also shorter in the SP group (64.5 seconds [IQR, 52.0-86.3 seconds] versus 74.0 seconds [IQR, 62.0-92.0 seconds], P = .001). Compared with the LHP, the SP had a lower pain score (3.3 versus 3.9, P = .002), a lower difficulty score (3.1 versus 3.7, P < .001), a lower frequency of position change (7.1% versus 38.0%, P < .001), and less need for abdominal compression (39.1% versus 45.5%, P = .02). SP was the only modifiable and independent factor identified to reduce CIT and pain score and improve patients' acceptance of unsedated colonoscopy. CONCLUSIONS: As an economical and convenient method, SP can reduce CIT, ease pain, and improve patients' acceptance of unsedated colonoscopy. (Clinical trial registration number: NCT03289442.).
RCT Entities:
BACKGROUND AND AIMS: Colonoscopy insertion is painful for some patients and is one of the main barriers to screening colonoscopy. Few studies have assessed the impact of the supine position (SP) on colonoscopy insertion, especially for unsedated patients. The aim of this randomized controlled trial was to clarify this issue. METHODS: Unsedated patients were randomized to SP or left horizontal position (LHP) as the starting position of colonoscopy insertion. The primary outcome measure was cecal intubation time (CIT), and the secondary outcome measures were descending colon intubation time (DIT), pain score of patients, difficulty score according to the endoscopist, and patients' acceptance of unsedated colonoscopy. RESULTS: A total of 347 patients were randomized to the SP group (175) or the LHP group (172). The CIT in the SP group was significantly shorter than that in the LHP group (275.0 seconds [interquartile range (IQR), 234.0-328.5 seconds] versus 316.0 seconds [IQR, 261.0-370.0 seconds], P < .001). The DIT was also shorter in the SP group (64.5 seconds [IQR, 52.0-86.3 seconds] versus 74.0 seconds [IQR, 62.0-92.0 seconds], P = .001). Compared with the LHP, the SP had a lower pain score (3.3 versus 3.9, P = .002), a lower difficulty score (3.1 versus 3.7, P < .001), a lower frequency of position change (7.1% versus 38.0%, P < .001), and less need for abdominal compression (39.1% versus 45.5%, P = .02). SP was the only modifiable and independent factor identified to reduce CIT and pain score and improve patients' acceptance of unsedated colonoscopy. CONCLUSIONS: As an economical and convenient method, SP can reduce CIT, ease pain, and improve patients' acceptance of unsedated colonoscopy. (Clinical trial registration number: NCT03289442.).
Authors: Ahmad Shavakhi; Mahsa Khodadoostan; Seid Javad Shariaat Nabavi; Sina Sadeghian; Ali Gholamrezaei; Alireza Shavakhi Journal: J Res Med Sci Date: 2021-06-30 Impact factor: 1.852
Authors: Daryl Ramai; Jameel Singh; Olivia W Brooks; Mohamed Barakat; Babu P Mohan; Saurabh Chandan; Shahab R Khan; Banreet Dhindsa; Amaninder Dhaliwal; Andrew Ofosu; Douglas G Adler Journal: Ann Gastroenterol Date: 2021-06-03