Optimal procedural sequence for same-day bidirectional endoscopy with moderate sedation: A prospective randomized study
| Autor: | Yi Ning Tsui, Cheng-Hui Lin, Shuo Wei Chen, Nai Jen Liu, Bai Ping Lee, Hsiang Ling Hung, Chi Liang Cheng, Jui Hsiang Tang, Yen Lin Kuo |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Hepatology medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Sedation Gastroenterology Colonoscopy Withdrawal time medicine.disease Surgery Endoscopy Fentanyl Colon polyps 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Anesthesia medicine Midazolam 030211 gastroenterology & hepatology medicine.symptom business medicine.drug |
| Zdroj: | Journal of Gastroenterology and Hepatology. 33:689-695 |
| ISSN: | 0815-9319 |
| Popis: | Background and Aim Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence for the procedure with moderate conscious sedation is not well-established. We investigated the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation in terms of sedation doses, patient discomfort, and colonoscopy performance. Methods We performed a prospective randomized controlled study of 120 patients who were scheduled for BDE examination. Colonoscopy followed by esophagogastroduodenoscopy (EGD) examination was performed in 60 patients (colonoscopy-EGD group) and EGD followed by colonoscopy examination was performed in another 60 patients (EGD-colonoscopy group). Endoscopists and patients completed a questionnaire to assess objective and subjective discomfort. Results Baseline demographics, procedure indications, bowel preparation quality, cecal intubation rate/time, colonoscopy withdrawal time, endoscopic interventions, BDE procedure time, colon polyp/adenoma detection rates, patient discomfort, and adverse events were similar between the two study groups. The total doses of fentanyl and midazolam were significantly higher for the colonoscopy-EGD group than for the EGD-colonoscopy group (83.4 ± 17.7 vs. 68.7 ± 18.6 μg and 6.3 ± 1.4 vs. 5.2 ± 1.3 mg, P < 0.0001 and P < 0.0001, respectively). The recovery time to discharge was significantly longer for the colonoscopy-EGD group than for the EGD-colonoscopy group (43.5 ± 16.2 vs. 34.5 ± 8.9 min, P = 0.0003). Conclusions EGD followed by colonoscopy is the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation. Following this order allows for a reduction of sedation doses and for shorter recovery times. |
| Databáze: | OpenAIRE |
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