Though colonoscopy is often performed with anesthesia, a recent study published in the journal Gastroenterology has found that sedation increases the risk of complications.1
A colonoscopy is a type of exam that a doctor uses to check the lining of the large intestine (colon) for signs of cancer, abnormal areas that could turn into cancer, or causes of gastrointestinal problems. To see inside the colon, a doctor (typically, a gastroenterologist who specializes in the gastrointestinal system) will place a thin flexible tube into the anus and slowly move the tube into the rectum and colon. This instrument, called a colonoscope, has a lens and light attached to it that sends images of the colon to a video screen.2 Learn more about colonoscopy here.
Colonoscopy can be performed with anesthesia or without. Many individuals choose anesthesia and doctors have recently reported the results of a study to evaluate whether there is a difference in complications from colonoscopy performed with or without anesthesia services.
The study authors analyzed administrative claims data from Truven Health Analytics MarketScan Research Databases from 2008 through 2011 and identified 3,168,228 colonoscopy procedures in men and women, aged 40–64 years old. Colonoscopy complications were measured within 30 days and included colonic (ie, perforation, hemorrhage, abdominal pain), anesthesia-associated (ie, pneumonia, infection, complications secondary to anesthesia), and cardiopulmonary outcomes (ie, hypotension, myocardial infarction, stroke).
Nationwide, 34.4% of colonoscopies were conducted with anesthesia services. Anesthesia use was associated with a 13 percent increase in the risk of any complications. The increased risk was associated specifically with an increased risk of perforation, hemorrhage, abdominal pain, complications secondary to anesthesia, and stroke.
Rates of anesthesia use also varied significantly by region; most notable was that 53% of doctors in the Northeast used anesthesia compared to only 8% in the West. In the Northeast, use of anesthesia services was associated with a 12% increase in risk of any complication.
The study authors concluded that the overall risk of complications after colonoscopy increases when individuals receive anesthesia services. The widespread adoption of anesthesia services with colonoscopy should be considered within the context of all potential risks and patients should discuss the risks and benefits of using anesthesia during colonoscopy for their situation.
- Risks Associated With Anesthesia Services During Colonoscopy; Karen J. Wernli, Alison T. Brenner,Carolyn M. Rutter ,John M. Inadomi; Gastroenterology in press.
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