Perioperative Complications of Colonoscopy Performed with Total Intravenous Anesthesia and Oral Sodium Phosphate for Bowel Preparation in Chumphae Hospital
Keywords:
Perioperative complication, Colonoscopy, Sodium phosphate, Total intravenous anesthesia, Hypokalemia, Duration of procedure, Anesthesia serviceAbstract
Objective: Colonoscopy is a gold standard procedure for colorectal cancer screening, thereby helping to reduce mortality. However, the procedure is allied with a higher incidence of complications. This study aimed to investigate colonoscopy complications and their associated factors, which have an impact on anesthesiology services.
Materials & Methods: This was a retrospective descriptive study conducted at Chumphae Hospital on a total of 334 patients who underwent colonoscopy between July 1, 2020 and June 30, 2021. Data were subjected to descriptive statistics, and univariate and multiple logistic regression analyses.
Results: The complications were revealed in 47.9% of the patients. Hypokalemia was the major adverse effect in 39.52% followed by cardiac arrhythmia (17.96%), hypotension (17.37%), and colonic perforation (0.3 %). The factors associated with complications were female (OR 2.54, p<0.01, CI=1.50-4.29), age (OR 1.03, p=0.02, CI=1.00-1.06), lower gastrointestinal bleeding (OR 2.93, p=0.01, CI=1.26-6.80), Potassium level before receiving sodium phosphate (OR 0.40, p<0.01, CI = 0.21-0.75), duration of procedure ( OR 1.02. , p=0.04, CI=1.00-1.04), and colonic polyp (OR 2.41, p<0.01, CI =1.25-4.64). Hypotension in colonoscopy patients was associated with stroke (OR 19.43, p=0.03, CI=1.30-288.56) whereas cardiac arrhythmia was linked to not receiving IV fluid containing potassium chloride (OR 0.47, p-value 0.02, CI = 0.24-0.91)
Conclusion: A large number of complications were observed from the colonoscopy, of which hypokalemia was the most common followed by arrhythmias and hypotension. Those with risk factors including females, elderly, colonic polyps, lower gastrointestinal tract bleeding, and stroke should be monitored for complications. In addition, the procedure should take no more than 30 minutes, and the patient should receive saline containing potassium chloride before undergoing colonoscopy.
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