Association of Body Mass Index (Bmi) and Sedative Use During Screening Colonoscopy: 2836

INTRODUCTION: Colonoscopy is a key tool for colorectal cancer screening, but like any procedure, it is not without risk. The procedure can be done with conscious sedation. Risks from sedation include hypotension or hypoxia, sometimes requiring hospitalization and even endotracheal intubation. Therefore, endoscopists aim to minimize the amount of sedation needed to keep a patient comfortable and still be able to complete the procedure. We sought to examine the relationship between a patient’s body mass index (BMI) and the amount of sedation used during colonoscopy. METHODS: Data was collected on 640 patients undergoing conscious sedation screening colonoscopies at Louisville Veterans Affairs Medical Center, and 501 were excluded based on specific exclusion criteria, including known colonic disorders (e.g., IBD history, pre-existing malignancies) and lack of documented sedative use. Of 139 patients included, median age was 62, 86% patients were male, and 72% were white. Data were gathered by retrospective chart review of patient’s BMI as well as dosage of Midazolam, Fentanyl, and Diphenhydramine used during colonoscopy. Multiple Regression Model was used for analysis with corresponding P -values calculated. Statistical significance was set at P < 0.05. The total number of polyps detected was controlled for, as this was thought to affect the duration of colonoscopy. RESULTS: Our study indicates that, although a higher BMI was hypothesized to be associated with increased sedative use, the association was not statistically significant for any of the three sedatives in this study. This is most likely due to the fact that there was little variability between the doses of each sedative and the small sample size. CONCLUSION: Data in literature is scarce regarding the association between BMI and sedation use for colonoscopy. Most society guidelines on sedation in obesity are based on expert opinion. Factors affecting sedation use include longer cecal intubation times due to difficult technique in patients with obesity, reluctance to use higher amounts of sedation in patients with obesity due to increased risk of airway compromise, and prior alcohol or drug use. Larger studies are needed to further explore these findings, which may have future clinical implications regarding the introduction of specific guidelines for sedative use in patients with obesity.