Navigation Links
Penn research offers road map to safer pain control, cost savings during colonoscopies
Date:3/11/2008

(PHILADELPHIA) At a time when several U.S. health insurers have discontinued payment for use of the sedative propofol during most screening colonoscopies, physicians at the University of Pennsylvania School of Medicine have discovered that an alternative way to administer the drug could both save millions of health care dollars and provide a safer way to deliver optimal pain relief.

The researchers studied two groups of patients who received patient-controlled sedation administered themselves with the push of a button during their colonoscopy. One group received a combination of the sedatives propofol and remifentanil, while the other received the drugs midazolam and fentanyl. Those in the propofol arm took only about half as long to be sedated, were able to walk quicker after the procedure, and spent much less time in the recovery room.

The findings, published in the February issue of the journal Anesthesia and Analgesia, shed additional light on Aetna, Humana and other large health insurers recent decisions to discontinue payment for the use of the sedative propofol during most routine colonoscopies, because it generally requires an anesthesiologist to be present to monitor for adverse reactions during the procedure. Their involvement adds several hundred dollars to the cost of the procedure, but without insurance coverage for this popular pain relief choice, physicians worry that more patients will avoid the lifesaving test, which detects and removes pre-cancerous polyps. Last year, 55,000 Americans died of colorectal cancer, making it the nations second-leading cancer killer.

Compliance with screening regimens will save lives at a rate several orders of magnitude greater than the number of lives lost to sedation, says Jeff E. Mandel, MD, MS, clinical associate professor Anesthesiology and Critical Care at Penn. As physicians, we should look for ways to find the optimal balance between access to care and risks. No ones interest is served by fewer patients having access to safe, painless colonoscopy.

Previous studies showed propofol helps patients relax quicker, and that can be associated with a more thorough exam. The Penn researchers say that blending patient-controlled IV propofol and remifentanil with continuous monitoring by an anesthesiologist similar to the way in which the doctors keep tabs on patients receiving epidural pain relief during labor and following many surgeries -- would provide patients with an ideal mix of pain relief and care from a trained anesthesiologist.

Since the researchers found that patients in the studys propofol/remifentanil arm were able to walk unassisted sooner after their procedure than those who received midazolam and fentanyl for sedation, the research also points to ways to reduce staffing in hospitals postanesthesia care units a major cost savings to third-party payers.

Any solution that ignores economic realities is doomed to failure, says Dr. Mandel. But no solution that ignores the best interest of patients is likely to succeed.


'/>"/>

Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Leading researchers honored for progress in cancer prevention, detection and treatment
2. WaferGen Launches SmartSlide 200 Micro-Incubation System for Stem Cell Research and Cell Biology Applications
3. Wasserman Morris Initiates Research Coverage on Crdentia
4. Research shows promise for potential new gene therapy strategy for muscle-wasting diseases
5. Mayo Clinic proceedings highlights research about cardiovascular benefits of omega-3 fatty acids
6. University of Pittsburgh researchers crack code of 3-D structure in key metabolic protein
7. UCF researchers discover a new protein family implicated in inflammatory diseases
8. Size does matter: Researchers adapt drug dosing to body size
9. Genetic research unveils common origins for distinct clinical diagnoses
10. Burroughs Wellcome Fund grants $9.75 million towards translational researchers
11. Researchers Design Promising Cancer Drug
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening their pencils ... an essay contest in which patients and their families pay tribute to a genetic ... 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... actively feeding the Frederick area economy by obtaining investment capital for emerging technology ... past 2½ years that have already resulted in more than a million dollars ...
(Date:6/24/2016)... Washington, D.C. (PRWEB) , ... June 24, 2016 , ... ... Pro-Am Heroes Golf Classic Tournament held on June 20th at the Woodmont Country ... local charity, Luke’s Wings, an organization dedicated to helping service members that have been ...
(Date:6/24/2016)... ... 2016 , ... Advanced Plastic Surgery Institute ( http://www.advancedplasticsurgeryinstitute.com ), ... official Medspa Sponsor. Dr. Josh Olson, a board-certified plastic surgeon, owns the practice, ... says the decision to support the pageant in an official capacity is a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... SAN CLEMENTE, Calif. , June 24, 2016  American Respiratory ... testing company, is now able to perform sophisticated lung assessments in ... Medical Technologies , Inc. Patients are no longer ... to ndd,s EasyOne PRO ® , ARL patients like Jeanne R. ... testing done in the comfort of her own home. ...
(Date:6/24/2016)... , June 24, 2016 ... appointment of Dr. Edward Futcher to ... Director, effective June 23, 2016.Dr. Futcher was also ... and Governance Committees.  As a non-executive member of ... expertise and strategic counsel to VolitionRx in connection ...
(Date:6/23/2016)... BEVERLY HILLS, Calif. , June 23, 2016 ... faced the many challenges of the current process. Many of ... option because of the technical difficulties and high laboratory costs ... would have to offer it at such a high cost ... to afford it. Dr. Parsa Zadeh , ...
Breaking Medicine Technology: