Effectiveness of warm water consumption to reduce patient discomfort during colonoscopy: a randomized controlled trial
Lee H, Kim JJ, Min BH, Lee JH, Kim YH, Chang DK, Kim JY, Rhee PL, Rhee JC
The American journal of gastroenterology · 8 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2009-07-28 · Am J Gastroenterol · vol. 104 · número 12 · págs. 2935–2941
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 12 citas · más que el 57% de estudios similares · 0.1× el promedio de su campo
- Referencias
- 16 trabajos
- Acceso
- De pago
- Áreas de investigación
- Colorectal Cancer Screening and Detection · Gastrointestinal motility and disorders · Anesthesia and Sedative Agents
- Palabras clave
- unsedated colonoscopy, colonic spasm, procedural pain, patient discomfort, sodium phosphate solution, cold water, irritable bowel syndrome, colonoscopy withdrawal time, young patients, bowel preparation
- MeSH
- humans, pain, phosphates, water, colonoscopy, pain measurement, treatment outcome, analysis of variance, logistic models, chi-square distribution, prospective studies, temperature, drinking, adult, female, male
9 autores
- Hyuk Lee🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Jae J. Kim🇰🇷 · autor de correspondenciaSamsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Byung‐Hoon Min🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Jun Haeng Lee🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Young-Ho Kim🇰🇷 · autor de correspondenciaSamsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Dong Kyung Chang🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Jin Yong Kim🇰🇷 · autor de correspondenciaSamsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Poong‐Lyul Rhee🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
- Poong‐Lyul Rhee🇰🇷Samsung Medical Center; Armed Forces Capital Hospital; Sungkyunkwan University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
Colonic spasm, a relatively common problem during colonoscopy, may interfere with intubation and examination. This study was conducted to compare the effect of warm water consumption before unsedated colonoscopy on the incidence of spasm, pain, and technical difficulties. In addition, we studied the associations between attributes of patients and the degree of pain experienced by them during procedures undertaken after warm water consumption.
Methods
A prospective, randomized, controlled, and investigator-blinded study was conducted in which three groups of patients underwent unsedated colonoscopies. Those randomized to group A (n=64) were instructed to drink 2 l of warm water and 90 ml of sodium phosphate (NaP) solution before colonoscopy. For comparison, those randomized to groups B (n=64) and C (n=64) were instructed to drink 2 l of cold water and 90 ml of NaP solution, or 90 ml of NaP solution without any additional water, respectively. Patient demographics, procedure-related factors, and degree of spasm, pain, and technical difficulty were assessed.
Results
Ileal intubation and withdrawal times were significantly shorter for group A than for groups B and C (P<0.001 and P<0.001, respectively). There was no significant difference between groups in the degree of spasm reported by the endoscopist. The level of pain at the sigmoid colon and splenic flexure during colonoscopy was lower for group A than for groups B and C on both advancement and withdrawal of the colonoscope (P<0.001 and P<0.001, respectively). The level of discomfort 2 h after the completion of endoscopy was lower for group A than for the other groups. (P=0.001). A subgroup analysis showed that warm water consumption was especially beneficial for patients <40 years of age and for those with irritable bowel syndrome. A multivariate analysis showed that warm water consumption before colonoscopy (odds ratio (OR) 0.22; 95% confidence interval (CI): 0.09-0.48 vs. the cold water group and OR 0.34; 95% CI: 0.16-0.73 vs. the no water group) was an independent factor for the reduction of pain during colonoscopy.
Conclusions
The intake of warm water before unsedated colonoscopy reduces procedure-related pain and technical difficulty, especially in patients who are young or have irritable bowel syndrome, even though it does not improve the frequency of visible spasmodic events.
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