Sedation and Cancer Screening Complications

Colorectal cancer screening patients who receive anesthesia are slightly more prone to complications

(RxWiki News) Maybe you've heard people say they don't want to have a colonoscopy because bad things can happen. True – bad things can happen, but complications are very unusual.

Two methods are used to put people to sleep during a colonoscopy - conscious sedation and deep sedation. A new study looked at colonoscopy complications associated with deep sedation.

Colonoscopy complications are rare. Less than 1 percent of individuals undergoing the colorectal cancer screening have problems.

Researchers have found, though, that complications are slightly higher in patients who were given deep sedation medications.

"Ask what type of sedation you will receive."

Serious complications (adverse events) caused by a colonoscopy are very unlikely. Still, some people will need to be hospitalized after this procedure.

Some patients may experience rupturing or trauma to the spleen, or the colon can accidentally be punctured (perforation). Also, some unconscious patients can suffer what’s called aspiration pneumonia, which is usually caused by vomiting during the procedure.

A group of researchers sought to learn if these complications were worse in people given deep sedation anesthesia.

Gregory S. Cooper, MD, of University Hospitals Case Medical Center in Cleveland, Ohio, led the study that analyzed the number of hospitalizations that occurred within 30 days of a colonoscopy.

Researchers evaluated a 5 percent random sample of Medicare patients in a Surveillance, Epidemiology and End Results (SEER) database.

The sample included a total of 100,359 individuals over the age of 65 who received 165,527 outpatient colonoscopies between January 2000 and November 2009.

A total of 21.2 percent – or 35,128 individuals – were given anesthesia for the procedure. The practice of using anesthesia has more than doubled in recent years, the authors noted.

Among all the 165,527 procedures, 284 patients had complications. This number equates to an absolute risk of 0.17 percent.

The most common complication was aspiration, suffered by 173 people. Colon perforation occurred in 101 individuals and 12 people had some form of spleen injury.

Researchers found that patients who were in deep sedation were more likely to have had complications (0.22 percent) compared to patients who were not given anesthesia (0.16 percent).

“Although the absolute risk of complications is low, the use of anesthesia services for colonoscopy is associated with a somewhat higher frequency of complications, specifically, aspiration pneumonia,” the authors concluded.

This study was published March 11 in JAMA Internal Medicine. The research was supported in part by grants from the National Cancer Institute at the National Institutes of Health and from the National Center for Advancing Translational Sciences at the National Institutes of Health. No conflicts of interest were reported.

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Review Date: 
March 11, 2013