Doğum deneyimi ile kolonoskopi ağrısı ilişkisinin değerlendirilmesi

Yıl 2024, Cilt: 23 Sayı: 3, 132 - 136, 25.12.2024

Mustafa Tahtacı , Hüseyin Köseoğlu , Öykü Tayfur Yürekli , Canan Türkan Fatma Ebru Akın Aylin Demirezer Bolat , Naciye Şemnur Büyükaşık , Murat Başaran , Osman Ersoy

https://doi.org/10.17941/agd.1606142

Öz

Giriş ve Amaç: Sedasyon altında olmayan kolonoskopi işleminde hastalar ağrı duyabilmektedir. Çalışmamızda doğum öyküsünün kolonoskopi ağrısı üzerine etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya kolonoskopi işlemi sırasında sedasyon uygulanmayan, normal doğum öyküsü olan 35 olgu ve doğum öyküsü olmayan 35 olgu dahil edildi. Olgular sırasıyla Grup 1 ve Grup 2 olarak sınıflandırıldı. Tüm olguların yaş, vücut kitle indeksi ve abdominal operasyon öyküsü kaydedildi. Tüm olgularda çekum entübasyon süresi, toplam işlem süresi, işlem öncesi anksiyete düzeyleri ve işlem sonrası vizüel analog skor değerleri kaydedildi. Vizüel analog skorun 75 mm üzerinde olması şiddetli ağrı olarak tanımlandı. Bulgular: Grup 2’de Grup 1’e göre yaş ve vücut kitle indeksi ortalaması anlamlı düşük, çekum entübasyon süresi ve vizüel analog skor ortalaması anlamlı yüksek bulundu (sırasıyla; p = 0.000, p = 0.001, p = 0.008, p = 0.000). Doğum öyküsünün olmaması şiddetli ağrı için anlamlı risk faktörü olarak saptandı (Odds oranı: 8.17; %95 güven aralığı: 2.68-24.93). Sonuç: Çalışmamızda doğum yapmamış olgularda vizüel analog skor anlamlı yüksek bulundu. Doğum öyküsünün olmaması kolonoskopi işleminin ağrılı olabileceğinin bir göstergesi olabilir. Bu olgularda sedasyonlu kolonoskopi tercih edilebilir.

Anahtar Kelimeler

Doğum, kolonoskopi, ağrı

Evaluation of the relationship between birth experience and colonoscopy pain

Öz

Background and Aims: Patients may feel pain during colonoscopy without sedation. In our study, we aimed to investigate the effect of birth history on colonoscopy pain. Material and Methods: The study included 35 cases with a history of normal childbirth who did not receive sedation during the colonoscopy procedure, along with 35 cases without a childbirth history. The cases were classified as Group 1 and Group 2, respectively. Age, body mass index and abdominal operation history of all patients were recorded. Cecal intubation time, total procedure time, anxiety levels before the procedure and visual analog score values after the procedure were recorded in all patients. Visual analog score over 75 mm was defined as severe pain. Results: In Group 2, the mean age and body mass index were significantly lower, cecal intubation time and visual analog score were significantly higher compared to Group 1 (p = 0.000, p = 0.001, p = 0.008, p = 0.000, respectively). Lack of a history of childbirth was found to be a significant risk factor for severe pain (Odds ratio: 8.17; 95% confidence interval: 2.68-24.93). Conclusion: In the study, visual analog scores were found to be significantly higher in cases without a history of childbirth. Lack of a history of childbirth may be an indication that colonoscopy may be painful. In these cases, sedation colonoscopy may be preferred.

Anahtar Kelimeler

Birth, colonoscopy, pain

Kaynakça

• 1. Rex DK, Anderson JC, Butterly LF, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2024;100(3):352-81.
• 2. Keswani RN, Crockett SD, Calderwood AH. AGA Clinical Practice Update on Strategies to Improve Quality of Screening and Surveillance Colonoscopy: Expert Review. Gastroenterology. 2021;161(2):701-11.
• 3. Hendel K, Hendel R, Hendel J, Hendel L. Pain perception during colonoscopy in relation to gender and equipment: a clinical study. Scand J Pain. 2020;20(4):747-53.
• 4. Riphaus A, Macias-Gomez C, Devière J, Dumonceau JM. Propofol, the preferred sedation for screening colonoscopy, is underused. Results of an international survey. Dig Liver Dis. 2012;44(5):389-92.
• 5. Birk J, Bath RK. Is the anesthesiologist necessary in the endoscopy suite? A review of patients, payers and safety. Expert Rev Gastroenterol Hepatol. 2015;9(7):883-5.
• 6. Cohen LB. Sedation issues in quality colonoscopy. Gastrointest Endosc Clin N Am. 2010;20(4):615-27.
• 7. Robinson ME, Gagnon CM, Dannecker EA, et al. Sex differences in common pain events: expectations and anchors. J Pain. 2003;4(1):40-5.
• 8. Cosic A, Ferhatovic L, Banozic A, et al. Pain catastrophizing changes during the menstrual cycle. Psychol Health Med. 2013;18(6):735-41.
• 9. Hapidou EG, DeCatanzaro D. Responsiveness to laboratory pain in women as a function of age and childbirth pain experience. Pain. 1992;48(2):177-81.
• 10. Aubrun F, Langeron O, Quesnel C, Coriat P, Riou B. Relationships between measurement of pain using visual analog score and morphine requirements during postoperative intravenous morphine titration. Anesthesiology. 2003;98(6):1415-21.
• 11. Pullens HJ, Siersema PD. Quality indicators for colonoscopy: Current insights and caveats. World J Gastrointest Endosc. 2014;6(12):571-83.
• 12. Bannert C, Reinhart K, Dunkler D, et al. Sedation in screening colonoscopy: impact on quality indicators and complications. Am J Gastroenterol. 2012;107(12):1837-48.
• 13. Triantafyllou K, Sioulas AD, Kalli T, et al. Optimized sedation improves colonoscopy quality long-term. Gastroenterol Res Pract. 2015;2015:195093.
• 14. Quaye AN, Hisey WM, Mackenzie TA, et al. Association between Colonoscopy Sedation Type and Polyp Detection: A Registry-based Cohort Study. Anesthesiology. 2024;140(6):1088-97.
• 15. Harewood GC, Wiersema MJ, Melton LJ 3rd. A prospective, controlled assessment of factors influencing acceptance of screening colonoscopy. Am J Gastroenterol. 2002;97(12):3186-94.
• 16. Ekkelenkamp VE, Dowler K, Valori RM, Dunckley P. Patient comfort and quality in colonoscopy. World J Gastroenterol. 2013;19(15):2355-61.
• 17. Hafner S, Zolk K, Radaelli F, et al. Water infusion versus air insufflation for colonoscopy. Cochrane Database Syst Rev. 2015;2015(5):CD009863.
• 18. Sajid MS, Caswell J, Bhatti MI, et al. Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials. Colorectal Dis. 2015;17(2):111-23.
• 19. Ladas SD, Satake Y, Mostafa I, Morse J. Sedation practices for gastrointestinal endoscopy in Europe, North America, Asia, Africa and Australia. Digestion. 2010;82(2):74-6.
• 20. Idhu R, Turnbull D, Haboubi H, et al. British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy. Gut. 2024;73(2):219-245.
• 21. Takahashi Y, Tanaka H, Kinjo M, Sakumoto K. Prospective evaluation of factors predicting difficulty and pain during sedation-free colonoscopy. Dis Colon Rectum. 2005;48(6):1295-300.
• 22. Holme O, Bretthauer M, de Lange T, et al. Risk stratification to predict pain during unsedated colonoscopy: results of a multicenter cohort study. Endoscopy. 2013;45(9):691-6.
• 23. Beck CT. Post-traumatic stress disorder due to childbirth: the aftermath. Nurs Res. 2004;53(4):216-24.
• 24. Graham-Engeland JE, Lobel M, DeLuca RS. Anger After Childbirth: An Overlooked Reaction to Postpartum Stressors. Psychol Women Q. 2002;26(3):222-33.
• 25. Yamada E, Watanabe S, Nakajima A. Associations of Mental Health and Physical Function with Colonoscopy-related Pain. Intern Med. 2017;56(4):383-8.
• 26. Joensuu J, Saarijärvi H, Rouhe H, et al. Maternal childbirth experience and pain relief methods: a retrospective 7-year cohort study of 85 488 parturients in Finland. BMJ Open. 2022;12(5):e061186.