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The use of ancillary techniques to aid colonoscope insertion

机译：使用辅助技术协助结肠镜插入

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Background: There is more to a high-quality colonoscopy than reaching the cecum or finding adenomas. Gentle insertion involves ancillary techniques, some of which are impossible in patients receiving deep sedation. The aim of this study was to assess the importance of ancillary techniques in achieving a comfortable, complete colonoscopy. Methods: This was a prospective study of 500 consecutive outpatient colonoscopies performed by a single endoscopist. During the procedure, note was taken of various ancillary techniques used to facilitate insertion: turning the patient, patient holding their breath, abdominal pressure. The success of these techniques in helping scope advancement was also noted. After the procedure the patient was asked to rate the severity of their pain and their degree of satisfaction with the examination. Results: A total of 238 women and 262 men participated in the study, and colonoscopy was complete in 96.2 and 98.5 %, respectively. Overall, 97 % of patients received versed alone (average dose 2 mg), and 3 % received a narcotic (average dose 46 U). Average pain score was 3.9 on a scale of 1 (least pain) to 10 (worst pain), and average satisfaction with the procedure as a whole was 9.5 on a similar scale. Ancillary techniques of holding breath, directed abdominal pressure, and turning to the left, right, and prone were used in 46, 56, 17, 23, and 4 % of examinations, respectively. Each technique was effective in helping insertion in over 70 % of cases. Turning the patient was also used to clear stool, open the colon, or facilitate polypectomy in another 33 cases. Multiple techniques were used in 49 % of patients. Conclusion: The use of ancillary techniques to facilitate colonoscope insertion helps avoid the expense and potential side effects of deep sedation.
机译：背景：高质量的结肠镜检查不仅仅可以达到盲肠或发现腺瘤。温和的插入涉及辅助技术，其中一些技术在接受深度镇静的患者中是不可能的。这项研究的目的是评估辅助技术在实现舒适，完整的结肠镜检查中的重要性。方法：这是一项前瞻性研究，由一名内镜医师对500例连续的门诊结肠镜检查进行检查。在手术过程中，记录了用于辅助插入的各种辅助技术：转动患者，屏住呼吸，腹压。还指出了这些技术在帮助扩大范围方面的成功。手术后，要求患者对疼痛的严重程度和对检查的满意程度进行评分。结果：总共238名女性和262名男性参加了这项研究，结肠镜检查的完成率分别为96.2％和98.5％。总体而言，有97％的患者单独接受曲普（平均剂量2 mg），有3％的患者接受麻醉剂（平均剂量46 U）。在1（最小疼痛）至10（最严重疼痛）的等级上，平均疼痛评分为3.9，在类似范围内，整个手术的平均满意度为9.5。分别在46％，56％，17％，23％和4％的检查中使用了屏住呼吸，定向腹部压力以及向左，向右和俯卧的辅助技术。每种技术都可以有效地帮助70％以上的病例插入。在另外33例患者中，还用转身病人清理粪便，打开结肠或促进息肉切除术。 49％的患者使用了多种技术。结论：使用辅助技术方便结肠镜插入有助于避免深度镇静的费用和潜在的副作用。

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