Endoscopy 2019; 51(04): S173
DOI: 10.1055/s-0039-1681682
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ANALGESIA WITH ENTONOX FOR COLONOSCOPY IN A COMMUNITY HOSPITAL

K Dabos
1   Endoscopy Unit, East Lothian Community Hospital, Haddington, United Kingdom
,
A Koulaouzidis
2   Endoscopy Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Over the last few years Entonox, a mixture of nitrous oxide and oxygen, has been offered as an option for analgesia during colonoscopy at our community hospital. We assessed the usefulness of Entonox analgesia by comparing colonoscopy quality parameters in patients who received entonox and those who received alfentanyl with or without an additional sedative.

Methods:

All colonoscopies performed between January 2017 and June 2018 were reviewed. Comfort scores during the procedure, caecal intubation rates (CIR) and polyp detection rates (PDR) were compared. Patients who started on Entonox but then required alfentanyl to complete the procedure were deemed Entonox failures. We used chi-square tests to analyse the data.

Results:

879 colonoscopies were assessed, performed by 5experienced operetorrs; 337 had Entonox only, 467 had alfentanyl, 34 had Entonox plus alfentanyl (Entonox failures) and 41 patients had colonoscopies without any medication hence excluded from the analysis.

Completion rates were similar in both groups (92.3% at the entonox group vs. 93.8% at the alfentanyl group). Comfort scores were similar between the two groups. There were 26 failed colonoscopies in the entonox group and 28 in the alfentanyl group. Only 2 patients without medication had incomplete colonoscopies Of the 34 patients who received alfentanyl after having tried entonox 26 completed the procedure and 8 did not. When completion rates were assessed there was a statistically significant difference in favour of the patients who received alfentanyl (OR 4.84 CI 0.39 – 4.52 p < 0.028). Polyp detection rate in the Entonox group was 24.8% and in the alfentanyl group was 32.4%. There was a trend towards higher detection rate with alfentanyl (p = 0.078).

Conclusions:

Patients opting for Entonox as analgesia should be aware that they might need additional analgesia and should have an established IV access Furthermore Entonox should not be offered as a first line analgesia in non-screening colonoscopy.