Is Anesthesia for Colonoscopy Safe?

Sometimes, we read about a study result that is widely publicized, yet we are reluctant to accept its absurd conclusions.   I’m sure there are studies buried somewhere that conclude that seat belts and bicycle helmets are dangerous and that cigarettes prolong life.   If such studies do exist, they would face mountains of contrary scientific evidence.  In other examples, a medical study’s conclusions may be false or misleading because the data are improperly or inadequately interpreted.   Consider this hypothetical study.  One hundred patients with rheumatoid arthritis (RA) patients and 100 control patients are questioned about their exercise habits.  Ten percent of RA patients exercise regularly in comparison to 40% of the control group.   The authors than conclude that exercise might protect against the development of RA.  There are many scientific reasons why this conclusion is erroneous including the probability that RA patients don’t exercise as much because they have arthritis.  In this simple example, you can get a glimpse of the scientific vulnerabilities of many studies that are presented to us as dogma.

When we read a study whose conclusions defies reason or our own life experience, we should summon up a generous measure of skepticism. 

Be Skeptical.  Think it over.

I have previously opined that adding an anesthesia professional (AP) to the colonoscopy team enhances patient safety.  So, when a study result was announced stating that adding this professional to the endoscopy team increased short term complications for patients, I paused to consider results that were contrary to my own professional knowledge and experience.   Assuming that the data were sound, a patient might conclude that adding an AP actually increased the risk of their colonoscopy and that they should request a different mode of sedation. 

If AP’s increase the safety of the endoscopy experience, as I claim, then why might their use be associated with a slightly higher unfavorable outcome rate?  (Remember, association does not mean causality.)  There may be several explanations for what sounds like an unexpected outcome.  Might it be true that AP’s are called in to assist on sicker patients who, in general, have higher complication rates for all medical procedures and surgeries?  Similarly, a surgeon who operates on sicker patients may have a higher complication rate than a colleague who chooses safer cases.  Does this mean that the first surgeon is a riskier choice?  Of course not.

If a person or an organization is advancing an argument that sounds silly, then maybe it is.