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In a randomized, controlled trial performed in two U.K. academic endoscopy centers, investigators compared colonoscopy insertion times in 152 patients who started colonoscopy in the left lateral decubitus (LL) or right lateral decubitus (RL) position.
The RL start position resulted in the following advantages (with similar doses of midazolam and fentanyl used between groups):
Faster median times to cecum (507 vs. 720 seconds; P<0.01) and transverse colon (281 vs. 408 seconds; P<0.01)
Better comfort (visual analog scale, 2 vs. 3; P=0.02)
Fewer changes to supine position (6.5 times more likely with LL vs. RL position; P<0.0001)
The absolute difference in speed of insertion between RL and LL positions decreased with experience of the endoscopist bu…