The study focused on a trend in the United Kingdom toward reduced sedative use during a colonoscopy in an effort to improve safety. Researchers recruited 109 patients, both male and female, to undergo colonoscopies. One hundred and three procedures were performed. Forty-three of the patients in the study received midazolam, is a very short-acting benzodiazepine that has potent anxiolytic, amnestic, hypnotic, anticulvulsant, skeletal muscle relaxant, and sedative properties.

Every two minutes during the exam patients were asked to grade their level of discomfort from 0 to 10 with 0 being the least uncomfortable and 10 being the most uncomfortable. The mean overall numeric rating scale score was 4.7. Men scored a mean rating of 4.0 and women a 5.2. The median peak score was 7. Discomfort was usually highest at the beginning of the procedure, while in the sigmoid colon.

The study found that discomfort scores were higher in patients with irritable bowel syndrome and diverticular disease. Patients who received midazolam were also more likely to express discomfort than those who received buscopan, an anti-spasmodic that works by relaxing the muscles in the wall of the gut, or nitrous oxide, an anesthetic and analgesic commonly known as laughing gas. Patients who had a preceding gastroscopy also expressed greater discomfort.

Researchers say the results also indicate that midazolam neither relieves discomfort nor makes patients forget the procedure, but some patients, such as those with a previous gastroscopy, females, and those with irritable bowel or diverticular disease may benefit from increased analgesia.

SOURCE: Fleet Attorney › Study of factors that contribute to discomfort during colonoscopy