Magnetic endoscopic imaging during colonoscopy is associated with less pain and decreased need of analgesia and sedation--results from a randomized controlled trial.

Objective. Colonoscopy is the method of choice for examining patients with lower gastrointestinal symptoms. The procedure is, however, in many cases, associated with pain and impaired compliance. Magnetic endoscopic imaging (MEI) generates a three-dimensional image of the colonoscope on a computer screen which may enable the colonoscopist to avoid looping, and consequently improve patient satisfaction. Material and methods. In this randomized controlled trial, 200 outpatients referred to colonoscopy at Ostfold Hospital Trust, Fredrikstad, Norway, were included. Patients were randomized to either the standard arm (using fluoroscopy on demand, n = 100), or the MEI arm (n = 100). End points were time to cecum, subjective pain experiences, and use of sedation or analgesics. Results. Out of a total of 200 patients, 54% were men. However, no significant differences between the groups according to gender were found. Fluoroscopy was applied in 23% of the cases in the standard group. Use of MEI was associated with decreased time to cecum (p < 0.05), decreased pain scores (Visual Analogue Scale, p < 0.05), decreased need of analgesia (p < 0.01), and decreased amount of administered midazolam and pethidin (p < 0.05 in both). Conclusions. MEI during colonoscopy was associated with decreased pain and less on-demand requests for sedation and analgesia. In addition, the use of MEI reduced the cecal intubation time. Consequently the implementation of magnetic endoscopic imaging in the endoscopy suits may be beneficial, particularly in the clinically difficult cases.