Upper gastrointestinal endoscopy: are preparatory interventions or conscious sedation effective? A randomized trial

Area of Science:

• Gastroenterology
• Patient Care
• Anxiety Management

Background:

• Patient anxiety and concerns regarding esophagogastroduodenoscopy (EGD) can negatively impact compliance and procedure execution.
• Conscious sedation (CS) and non-pharmacological interventions are explored to mitigate anxiety and enhance EGD tolerance.

Purpose of the Study:

• To evaluate the effectiveness of conscious sedation (CS) compared to supplementary information (videotape) or the presence of a relative in improving EGD tolerance.

Main Methods:

• 226 outpatients undergoing their first non-emergency EGD were randomized into four groups: throat anesthesia only (Co-group), CS with midazolam (Mi-group), presence of a relative (Re-group), or videotape information (Vi-group).
• Anxiety was assessed using the Spielberger State and Trait Anxiety Scales.
• Patient and endoscopist evaluations of discomfort and tolerance were recorded using visual analogue scales and questionnaires.

Main Results:

• The CS group (Mi-group) reported significantly better EGD tolerance (80.7%) compared to the other groups (Co-group: 43.5%, Re-group: 58.6%, Vi-group: 50%).
• Both patients and endoscopists reported lower discomfort levels in the CS group.
• Factors associated with poorer tolerance included male gender and younger age.

Conclusions:

• Conscious sedation is an effective method for improving patient tolerance during esophagogastroduodenoscopy.
• Male gender and younger age are identified as predictors of reduced tolerance to EGD.