Colonoscopy Patients Opt for Painless Approach


March 21, 2012

MedPage Today

MedPageToday reports that more patients underwent general anesthesia during gastroenterological procedures such as colonoscopy between 2003 and 2009, according to a new study. Most of that use occurred in low-risk patients, which suggests that a "substantial share of the spending for gastroenterology anesthesia may be considered potentially discretionary," they wrote. The study was limited because patient risk levels were estimated, and because the researchers couldn't assess the actual clinical need for anesthesia in individual patients. In an accompanying editorial to the new study, Lee Fleisher, MD, chair of the department of Anesthesiology and Critical Care, cautioned that this latter limitation may be of importance. Patient acceptance of endoscopy and colonoscopy, Fleisher explained, may be related to the assurance of deep sedation or general anesthesia for the procedures. Thus, strategies that increase adherence with screening guidelines may be cost-effective, he wrote. Clinicians may also rely on anesthesia to reduce medicolegal consequences and take overall costs into account, he added. Fleisher concluded that "careful implementation of new policies regarding 'potentially' discretionary services need to incorporate the patient and clinician perspective while continuing to implement change that bends the cost curve." Read More

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