In minimally sedated Asian patients in a community setting the investigators showed that a limited volume of water infusion instead of air insufflation in either the rectal sigmoid colon or the whole colon significantly reduced pain score during colonoscopy. Cecal intubation rate was not compromised. The reduction of pain score ranges from 25% to 32 % in our previous studies.1, 2 In contrast, several US reports described the successful use larger volumes of water infused throughout the entire colon in patients undergoing colonoscopy which result in a greater reduction of the pain score, averaging about 56%.3-5 A recent review suggested that the cause of the difference might lies in the timing of water removal.6 Specifically, the investigators group removed the infused water predominantly during withdrawal phase (water immersion) and the U.S. group removed water during insertion phase (water exchange). This prospective, randomized controlled trial compared water exchange or water immersion with traditional air insufflation in patients undergoing minimally sedated colonoscopy. The investigators test the hypothesis that water exchange can reduce more pain than water immersion in the investigators clinical setting.
All procedures will be recorded and stored as digital files.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
DOUBLE
Enrollment
270
insufflate air during the insertion of colonoscopy
infuse water during insertion, aspirate water during withdrawal
infuse and remove water during insertion phase of colonoscopy
Dalin Tzu Chi General Hospital
Chiayi City, Taiwan, Taiwan
Proportion of Patients Without Pain
proportion of patients without insertion pain during colonoscopy
Time frame: up to 12 months
Patient Pain Score
The maximal pain score during insertion phase of colonoscopy was assessed with 0 to 10 scale VAS score (0: no pain; 10: maximal pain)
Time frame: 9 to 12 months
Patient Satisfaction Score
satisfaction score obtained after colonoscopy 0 = no satisfied; 10 = most satisfied
Time frame: 9 to 12 months
Number of Participants With at Least One Adenoma
the number of participants with at least one adenoma in each of the study groups.
Time frame: 9 to 12 months
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