KOVACEVIC M, RIZVANOVIC N, SABANOVIC ADILOVIC A, BARUCIJA N, ABAZOVIC A. Adenoma Detection Rate in Colonoscopic Screening with Ketamine-based Sedation: A Prospective Observational Study.
Medeni Med J 2022;
37:79-84. [PMID:
35306793 PMCID:
PMC8939457 DOI:
10.4274/mmj.galenos.2022.75282]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective:
This study aimed to determine the relationship between one of the most commonly used anesthesia techniques, ketaminebased sedation, on the value of adenoma detection rate (ADR) during colonoscopy screening.
Methods:
This prospective, observational study included 140 patients, who underwent a standard colonoscopy preparation before the procedure. Sedation regimens included ketamine at 0.5 mg/kg and propofol at 0.5 mg/kg. Additional doses of propofol were administered at 0.5 mg/kg to maintain the Ramsey Sedation scale. Baseline characteristics, ADR, bowel preparation quality according to the Chicago bowel preparation (CHBP) scale, cecal intubation, colonoscopy removal, and complications were analyzed.
Results:
The mean age of patients was 55.76 years; 40 (28.6%) were males and 100 (71.4%) were females. The ADR was 43.57%, wherein 15.71% in males and 27.86% in females. There were 43.6% adenomas, 17.9% biopsies, and 22.9% polypectomies. The largest location of adenomas/polyps were in the rectum and sigmoid and ascending colon (p=0.11), a biopsy of the sigmoid colon and ileum (p<0.05), polypectomy of the rectum and sigmoid and ascending colon (p<0.05). The cecal intubation was 93.6% with a withdrawal time that is >6 min in most patients (80%) (p<0.05). The CHBP scale showed good bowel preparation (p<0.05) without complications.
Conclusions:
Ketamine-based sedation is in good overall correlation with ADR. Therefore, the sedation technique should be included for ADR assessment in the future.
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