Acceptability of oesophagogastroduodenoscopy without intravenous sedation: patients’ versus endoscopist’s perception with special reference to older patients

Thanvi, Bhomraj; Munshi, S K; Vijayakumar, N; Taub, Nicholas; Lo, T C N

doi:10.1136/pmj.79.937.650

Cited by 19 publications

(17 citation statements)

References 11 publications

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“…This restricted strategy is based on insufficient evidence and cost–benefit analysis to support a re‐biopsy strategy for every CD patient. Another significant problem is that oesophogastroduodenoscopy is often poorly tolerated, which results in problems if all patients are mandated to undergo this intervention for follow‐up biopsies .…”

Section: Methodsmentioning

confidence: 99%

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Kurien

Trott

Sanders

2016

J Human Nutrition Diet

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Coeliac disease is a common digestive disorder that affects 1% of adults. It is characterised by mucosal damage of the small intestine caused by dietary gluten. The main treatment for coeliac disease is a lifelong gluten‐free diet, which can reduce morbidity and mortality and also improve quality of life. Despite the benefits, adhering to this diet is often challenging, with patients often struggling to sustain dietary restriction. Structured follow‐up for coeliac disease is recommended in international guidelines for improving adherence and for detecting complications;however, uncertainty exists concerning exactly who should be administering this follow‐up care. Here, we undertake a review of the current approaches described in the literature to follow‐up patients with coeliac disease, and assess the efficacy of these differing models. We also explore future directions for the care of these patients in the context of the UK National Health Service (a publicly funded healthcare system). Although the focus of this review pertains to follow‐up within the UK healthcare system, these problems are recognised to be international, and so the findings of our review are likely to be of interest to all healthcare professionals seeing and managing patients with coeliac disease.

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Section: Methodsmentioning

confidence: 99%

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Kurien

Trott

Sanders

2016

J Human Nutrition Diet

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“…The dose should be cautiously determined taking into consideration the clinical conditions such as the general condition and age of the patient, types of treatment and predicted treatment duration etc. Recently, it was reported that sedation with drugs used for general anesthesia such as propofol provided efficacy and safety comparable or superior to that with a low‐dose benzodiazepine . However, monitoring and observation by an assistant is necessary because biological protective reflexes are suppressed.…”

Section: Statements On Sedation In Gastroenterological Endoscopymentioning

confidence: 99%

“…Recently, it was reported that sedation with drugs used for general anesthesia such as propofol provided efficacy and safety comparable or superior to that with a low-dose benzodiazepine. [60][61][62][63][64][65][66][67][68] However, monitoring and observation by an assistant is necessary because biological protective reflexes are suppressed. Sedation with any drug mentioned above should be carried out under circumstances in which airway management and tracheal intubation are readily available.…”

Section: Commentarymentioning

confidence: 99%

Guidelines for sedation in gastroenterological endoscopy

Obara

Haruma

Irisawa

et al. 2015

Digestive Endoscopy

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Recently, the need for sedation in gastrointestinal endoscopy has been increasing. However, the National Health Insurance Drug Price list in Japan does not include any drug specifically used for the sedation. Although benzodiazepines are the main medication, their use in cases of gastrointestinal endoscopy has not been approved. This has led the Japan Gastrointestinal Endoscopy Society to develop the first set of guidelines for sedation in gastrointestinal endoscopy on the basis of evidence‐based medicine in collaboration with the Japanese Society for Anesthesiologists. The present guidelines comprise 14 statements, five of which were judged to be valid on the highest evidence level and three on the second highest level. The guidelines are not intended to strongly recommend the use of sedation for gastrointestinal endoscopy, but rather to indicate the policy as to the choice of appropriate procedures when such sedation is deemed necessary. In clinical practice, the final decision as to the use of sedation should be made by physicians considering patient willingness and physical condition.

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“…3 On the other hand, some research shows no relationship between tolerance and age. 18 There are factors involved in preparing for the examination and carrying it out that have a significant impact on the well-being of the patient. Some studies suggest that reliable information before a gastroscopy has a positive influence on the patient's distressing feelings.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting patient tolerance of unsedated upper gastrointestinal tract endoscopy

Maślanka-Seiffert¹,

Seiffert²,

Olchowska-Kotala³

et al. 2020

Piel. Zdr. Publ.

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Background. Endoscopy of the upper gastrointestinal tract is a widely used diagnostic procedure. It can be a source of anxiety, discomfort and even pain for the patients.Objectives. The aim of the study was to assess the discomfort and anxiety associated with gastroscopy, examine their determinants and describe patients' preferences regarding medical procedures and personnel behavior.Material and methods. The study involved 50 patients (21 men and 29 women) who underwent an endoscopy of the upper gastrointestinal tract. The State-Trait Anxiety Inventory (STAI) was employed, as well as the authors' own two-part questionnaire, which was conducted before and after the endoscopy.Results. The average level of anxiety was 40.72 STAI points and the emetic reflex was its main source (52%). The average level of discomfort felt during the gastroscopy was 2.84 and was related to both age (p = 0.001), security and privacy during the examination (p = 0.03), as well as to the level of anxiety prior to examination (p = 0.05). The severity of the discomfort was not associated with gender, education or subjective assessment of knowledge about the examination. Half of the patients would have liked to be sedated. A majority of the respondents (61%) indicated that verbal reassurance is a desirable form of behavior of the medical staff.Conclusions. The main cause of patients' anxiety is fear of the discomfort associated with the emetic reflex. The discomfort experienced by patients during endoscopy is linked to their age group, with younger participants experiencing greater discomfort, higher levels of anxiety prior to the examination, and a lower sense of security and privacy. Patients value verbal reassurance, procedural information and behavioral instructions during the endoscopy. General sedation is preferred by patients. Cite asMaślanka-Seiffert B, Seiffert P, Olchowska-Kotala A, Kempiński R. Factors affecting the tolerance of the unsedated upper gastrointestinal tract endoscopy. Piel Zdr Publ. StreszczenieWprowadzenie. Endoskopia górnego odcinka przewodu pokarmowego jest rozpowszechnionym badaniem diagnostycznym. Może stanowić dla pacjenta źródło lęku, dyskomfortu, a nawet bólu.Cel pracy. Celem badania była ocena dyskomfortu i lęku związanego z gastroskopią, zbadanie ich determinantów oraz określenie oczekiwań pacjentów odnośnie do procedur medycznych i zachowania personelu.Materiał i metody. Przebadano 50 pacjentów (21 mężczyzn i 29 kobiet) poddanych endoskopii górnego odcinka przewodu pokarmowego. Do badania wykorzystano Inwentarz Stanu i Cechy Lęku STAI oraz dwuczęściową autorską ankietę przeprowadzaną przed endoskopią i po niej.Wyniki. Średni poziom lęku wynosił 40,72 pkt STAI, a odruch wymiotny był jego głównym źródłem (52%). Średni poziom odczuwanego dyskomfortu podczas gastroskopii wynosił 2,84 i był związany zarówno z wiekiem (p = 0,001), bezpieczeństwem i prywatnością podczas badania (p = 0,03), jak i poziomem lęku przed badaniem (p = 0,05). Nasilenie dyskomfortu nie było związane z płcią, wykształceniem i subiektywną ...

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Acceptability of oesophagogastroduodenoscopy without intravenous sedation: patients’ versus endoscopist’s perception with special reference to older patients

Cited by 19 publications

References 11 publications

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Guidelines for sedation in gastroenterological endoscopy

Factors affecting patient tolerance of unsedated upper gastrointestinal tract endoscopy

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