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Impact of moderate versus deep sedation on adenoma detection rate in index average-risk screening colonoscopies.

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BACKGROUND AND AIMS The debate between moderate sedation versus deep sedation for index average-risk screening colonoscopies is well known to gastroenterologists. Ensuring the best of all metrics to perform quality… Click to show full abstract

BACKGROUND AND AIMS The debate between moderate sedation versus deep sedation for index average-risk screening colonoscopies is well known to gastroenterologists. Ensuring the best of all metrics to perform quality colonoscopies for colon cancer prevention is paramount for both patients and physicians alike, as colon cancer remains the leading cause of cancer death and is the most-used screening tool in the United States. The aim of this study was to determine if moderate sedation versus deep sedation affects outcomes of adenoma detection rate (ADR) or polyp detection rate (PDR) in index, average-risk colonoscopies for colon cancer screening. METHODS A retrospective, single tertiary-care outpatient center study of 585 healthy average-risk patients who underwent index screening colonoscopy between June 1, 2015, to December 31, 2015 (moderate sedation only) and June 1, 2016, to December 31, 2016 (deep sedation only) was performed after Institutional Review Board approval. Demographic data and polyp details were collected to determine ADR and PDR. Patients who were not average-risk were excluded from the study. RESULTS A total of 585 index average-risk screening colonoscopies were included in this study with 57.7% moderate sedation and 42.2% deep sedation. ADR was not significantly different between the 2 groups (44.1% vs 38.5%, p=0.18) and neither was PDR (71.9% vs 67.6%, p=0.27). CONCLUSION In index average-risk screening colonoscopies, deep sedation appears to have no benefit compared with moderate sedation for ADR and PDR.

Keywords: deep sedation; index; average risk; sedation

Journal Title: Gastrointestinal endoscopy
Year Published: 2019

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