Acupuncture reduces need for sedation during colonoscopy
20 February 2003
Am J Gastroenterol 2003; 98: 312-316

Acupuncture may be able to reduce the need for sedation during colonoscopy, study findings suggest in the American Journal of Gastroenterology.

"Colonoscopy is considered highly invasive and is generally assumed to be an uncomfortable and often painful procedure," Lorella Fanti (San Raffaele Hospital, Milan, Italy) and colleagues observe.

Although the use of sedation has become standard practice to achieve a satisfactory level of relaxation, co-operation, and amnesia during the procedure, this increases both the cost and complications of colonoscopy.

The team therefore conducted a randomized, placebo-controlled study to compare the effectiveness of acupuncture and sedation in reducing discomfort, pain, and anxiety during colonoscopy.

Thirty patients were randomly assigned to receive acupuncture with electrical bilateral stimulation at five points for sedation and abdominal distention, sham acupuncture at five non-active points, or no acupuncture.

Midazolam boluses were administered 15 minutes before the procedure and whenever severe pain was described using a verbal rating scale. In particular pain was recorded when the endoscope reached the rectal-sigma, the sigma-colon, splenic flexure, and the hepatic flexure.

Overall, additional midazolam boluses were required by three patients receiving acupuncture, eight given sham treatment, and nine controls.

In addition, six patients given acupuncture reported "optimum acceptance" of colonoscopy on an acceptability score for discomfort compared with just one patient receiving sham treatment, and none of the control group.

Nevertheless, satisfaction scores reported 24-72 hours after colonoscopy were extremely high in all treatment groups.

Noting that patient groups were homogenous for age, body weight, gender, precolonoscopy anxiety, time to reach cecum, and total procedure time, Fanti et al conclude that their results "demonstrate that electroacupuncture provides adequate sedation during colonoscopy with a better patient acceptance of the procedure and minimal need of pharmacological sedation.

"Further studies are needed to determine whether these results may be reproducible when, after adequate training, endoscopists themselves will perform acupuncture during colonoscopy."

Journal abstract [subscription required]

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