A randomized trial of peroral versus transnasal unsedated endoscopy using an ultrathin videoendoscope
A randomized trial of peroral versus transnasal unsedated endoscopy using an ultrathin videoendoscope
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DOI：
10.1016/s0016-5107(99)70001-5
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发表时间：
1999-03-01
影响因子：
7.7
通讯作者：
Katon, RR
中科院分区：
文献类型：
--
作者：
Zaman, A;Hahn, M;Katon, RR
背景资料：非镇静内镜检查的潜在优势包括预防与使用镇静药物相关的副作用或发病率，减少对患者的监护，以及降低费用。我们比较了经鼻（T-EGD）与经口（P-EGD）的非镇静内镜检查，通过使用一个video instrument.Method的患者的耐受性和接受度：患者被随机分为T-EGD或P-EGD。如果初始插入路径失败，则将患者交叉至另一路径。如果这也失败了，患者在清醒镇静下使用内窥镜检查仪进行内窥镜检查。由患者完成耐受性问卷调查（经验证的0-10量表，其中“0”表示无/耐受良好，“10”表示严重/耐受不良）。P-EGD组中有20名男性和11名女性（平均年龄45岁），T-EGD组中有15名男性和14名女性（平均年龄48岁）。在35例P-EGD患者中（4例与T-EGD患者交叉），34例（97%）完成了未镇静检查。在29例T-EGD患者中，25例（86%）进行了完整的检查。3例T-EGD检查因解剖原因失败;所有3例患者在交叉至P-EGD途径时均成功检查。1例患者无法耐受任何一种途径。在P-EGD组和T-EGD组之间，术前焦虑（3.6 +/- 0.5 vs. 3.0 +/- 0.6），插入期间不适（2.1 +/- 0.5 vs. 3.3 +/- 0.7）、呕吐（4.7 +/- 0.5 vs. 3.2 +/- 0.6）和总体耐受性（2.4 +/- 0.5 vs. 3.8 +/- 0.7）相似（p > 0.05）。然而，T-EGD组插入时的不适感显著高于P-EGD组（4.4 +/- 0.6 vs. 2.7 +/- 0.5：p < 0.05）。百分之八十九的P-EGD患者和69%的T-EGD患者，p = 0.07，愿意接受unseeded内镜在future.Conclusion T-EGD患者经历了显着更多的疼痛插入比P-EGD患者。否则，经鼻或经口途径的非镇静内镜检查通常耐受良好。在这项研究中，60名患者中有59名完成了这项研究。
Background: Potential advantages of unsedated endoscopy include the prevention of side effects or morbidity related to the use of sedative drugs, less intensive patient monitoring, and less expense. We compared transnasal (T-EGD) with peroral (P-EGD) unsedated endoscopy by using an ultrathin video instrument with respect to patient tolerance and acceptance.Method: Patients were randomized to T-EGD or P-EGD. If the initial route of insertion failed, the patient was crossed over to the other route. If this also failed, the patient underwent endoscopy under conscious sedation with an ultrathin instrument. A questionnaire for tolerance was completed by the patient (a validated 0-10 scale where "0" represents none/well tolerated and "10" represents severe/poorly tolerated).Results: Of 105 recruited patients, 60 consented to undergo unsedated endoscopy. There were 20 men and 11 women (mean age 45 years) in the P-EGD group and 15 men and 14 women (mean age 48 years) in the T-EGD group. Of 35 total P-EGD patients (4 were crossed over T-EGD patients), 34 (97%) completed an unsedated examination. Of 29 T-EGD patients, 25 (86%) had a complete examination. Three T-EGD examinations failed for anatomical reasons; all 3 patients when crossed over to the P-EGD route had a successful examination. One patient was unable to tolerate either route. Between the P-EGD and the T-EGD groups, pre-procedure anxiety (3.6 +/- 0.5 vs. 3.0 +/- 0.6), discomfort during insertion (2.1 +/- 0.5 vs. 3.3 +/- 0.7), gagging (4.7 +/- 0.5 vs. 3.2 +/- 0.6), and overall tolerance (2.4 +/- 0.5 vs. 3.8 +/- 0.7) were similar (p > 0.05). However, discomfort on insertion was significantly greater in the T-EGD versus the P-EGD group (4.4 +/- 0.6 vs. 2.7 +/- 0.5: p < 0.05). Eighty-nine percent of P-EGD patients and 69% of T-EGD patients, p = 0.07, were willing to undergo unsedated endoscopy in the future.Conclusion T-EGD patients experienced significantly more pain on insertion than did P-EGD patients. Otherwise, unsedated endoscopy by either the transnasal or the peroral route is generally well tolerated. In this study it was completed in 59 of 60 patients.