Moderate sedation or monitored anesthesia care for colonoscopies: Is there a difference?

Abstract

To determine whether monitored anesthesia care (MAC) results in shorter colonoscopy time. A retrospective chart review from electronic medical records at Sentara Norfolk General Hospital was performed of all patients seen by the Eastern Virginia Medical School Department of Surgery who underwent a screening or diagnostic colonoscopy from December 2015 to July 2017. The primary end point is procedure time, with secondary end point of sedation time. There is a statistically significant difference in time to cecum between moderate sedation (MOD) and MAC (P = 0.002). Operator perceived difficulty is statistically associated with increased time to cecum (P < 0.0001). Time to cecum between MOD and MAC over the levels of difficulty was not significant (P = 0.403). A subanalysis looking at time to cecum between MOD and MAC for each level of difficulty showed a significant effect when difficulty was described as no difficulty. There is a statistically significant difference in time to scope insertion between MOD and MAC (P < 0.0001). Our data show that, taken as a conglomerate, the procedure and sedation time is shorter in MAC than in MOD. The use of MAC is associated with decrease time to scope insertion and overall time to cecum.