Saudi Journal of Gastroenterology
Home About us Instructions Submission Subscribe Advertise Contact Login    Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Users Online: 862 
ORIGINAL ARTICLE
Year : 2016  |  Volume : 22  |  Issue : 1  |  Page : 64-68

Factors influencing challenging colonoscopies during anesthesiologist-assisted deep sedation


1 Department of Surgical and Gastroenterological Science, Padova University Hospital, Padova, Italy
2 Department of Internal Medicine, National Research Council, Institute of Neuroscience, Padova, Italy
3 Department of Anesthesia and Intensive Care, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy

Correspondence Address:
Dr. Fabrizio Cardin
Department of Geriatric Surgery, Geriatric Division, Ospedale Giustinianeo, Università di Padova, Via Giustiniani, 2, Padova 35100
Italy
Login to access the Email id

Source of Support: The authors received no funding for this study,, Conflict of Interest: None


DOI: 10.4103/1319-3767.173761

Rights and Permissions

Background/Aim: Increased demand for colon cancer screening procedures can significantly impact on routine colonoscopy management at dedicated facilities, prompting a review of the factors that can negatively affect workflow. Although potential adverse effects and impact on costs of deep sedation have been documented elsewhere, this study focuses on variables that can influence performance of colonoscopy in deep sedation and interfere with normal procedure scheduling in settings where the presence of an anesthesiologist is mandatory. Patients and Methods: We performed a cross-sectional study of the activities of a colonoscopy screening unit, applying Bayesian Network (BN) analysis, designed to assess interdependencies among variables that can affect a process in complex, multidimensional systems. The study was performed at a teaching hospital where endoscopists and anesthesiologists of varying work experience operate on a rota basis. During a six-month period, we analyzed 1485 consecutive colonoscopies performed under deep propofol sedation, administered by an anesthesiologist via hand-controlled syringe. The BN was constructed with the variables: Gender, age, ASA status, bowel preparation, baseline blood pressure, endoscopist's experience, anesthesiologist's experience, presence of polypectomy, and the target node, "challenging procedure." This previously undefined category refers to any events disrupting the scheduled rota. Result and Conclusion: Two distinct networks were identified. One deals mainly with relationships among the variables, patients' demographic and clinical characteristics (procedures with polypectomy, ASA and baseline blood pressure). The other explains relationships among the variables, "challenging procedure," bowel preparation, and endoscopist's experience. The factors associated with the anesthesiologist's activity do not influence challenging colonoscopies.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1306    
    Printed21    
    Emailed0    
    PDF Downloaded190    
    Comments [Add]    

Recommend this journal