Consecutive outpatients undergoing colonoscopy from September 9th 2004 to July 12th 2005 were included. All patients received a standard preparaton with 3 oz of Fleets phosphasoda and a clear liquid diet 24 hours prior to their procedure. Pentax EC-3430L and Pentax EC-3480TL colonoscopes were used. Sedation was achieved with incremental doses of Versed and Fentanyl intravenously. BP, EKG and pulse oximetry were performed in all patients. Nasal cannula O2 at 3 L/min was administered routinely.
 
The air pump was switched off prior to inserting the colonoscope. The air/water channel was primed with water. With a 60 cc syringe, small volumes of water (10-15 cc) at body temperatue were manually introduced at a time until cecal intubation was achieved. Generally not more than 240 cc were necessary.
 
Air inflation was used on withdrawal or to confirm cecal landmarks such as the appendiceal opening, triradiate fold and ileocecal valve. Procedural time, intubation and withdrawal times, medication dosage and subjective pain assessment were recorded.
 
Subjective pain assessment was done immediately postprocedure by either the doctor or nurse. Pain assessment was measured using a simple pain chart and asking the patient to assess their overall experience of the insertion and withdrawal of the scope.