Susanne Eberl

Chapter 6

of clinical suspicion for colorectal cancer. Prone position was the first acquisition position

when intravenous contrast was used and the second scan position when only unenhanced

acquisitions were performed.

Evaluation during procedure

Pain scores were assessed with an 11-point numeric rating scale at the end of prone scan

acquisition position and for all three insufflation positions (0 = no pain and 10 = worst pain

imaginable).

During the procedure, patients’ vital parameters were monitored (PM50, Contec Medical

Systems CO, LTD, Qinhuangdao, China). We registered values at standard time points: before

spasmolytic injection, 1½ minutes after spasmolytic injection and at 5 and 10 minutes after

starting the alfentanil injection. The value 1½ minute after spasmolytic injection was the

reference value for comparisons with values after study medication injection, because the

spasmolytic can influence the vital parameters.

Heart rate and oxygen saturation were

measured continuously with the same device and stored measurements were analysed

afterwards. Furthermore all side effects and the time in the scanner room were recorded.

Monitoring

To evaluate recovery after the procedure, the Aldrete score, a commonly used recovery

score,

36,37

was assessed at arrival in the waiting room and at 30 and 60 minutes after

administration of the study medication (Figure 1).

Questionnaires

Baseline characteristics, procedure expectations, and procedure experience were assessed

using a pre- and post-procedural questionnaire and largely originated from a previous

study.

The pre-procedural questionnaire consisted of 22 questions andwas filled out before

randomisation and the post-procedural questionnaire consisted of 17 questions and was

filled out 30 minutes after the procedure. Questions about expectations included burden

and pain of the bowel preparation, intravenous cannula insertion, bowel insufflation, and

the total procedure on a standard formatted 5-point scale (not at all, slight, some, rather,

and extremely). Identical questions on experience were asked using the same standard

formatted 5-point scale. Further, the most painful or burdensome aspect was assessed, and

whether they would accept CT colonography as a screening test.