Safety and acceptance of non-sedated upper gastrointestinal endoscopy: a prospective observational study

The study was conducted to assess the patient acceptability of non-sedated upper gastrointestinal (GI) endoscopy and to study cardiorespiratory changes during the procedure.

This study was conducted in the outpatient endoscopy room of Department of Surgery of a teaching tertiary-care hospital in North India. The patients underwent diagnostic GI endoscopy under topical pharyngeal anesthesia using 5% lidocaine. No sedation was used. Pulse rate (PR), respiratory rate (RR), oxygen saturation (SpO(2)), and mean blood pressure (BP) were recorded immediately prior to endoscopy, during endoscopy, and 5, 15, and 30 minutes after endoscopy. Using a 10-point Likert scale, all the patients were asked to record their expected discomfort for the endoscopy as a pre-test score and their actual level of discomfort during endoscopy as a post-test score. Patients were also asked about whether they would opt for non-sedated upper GI endoscopy again in the future if required.

Sixty patients underwent diagnostic upper GI endoscopy during the study period. Post hoc tests using Bonferroni's correction revealed that mean PR, RR, and mean BP changed significantly during endoscopy. However, these parameters normalized at 30 minutes following endoscopy. Mean SpO(2) did not differ significantly at the different time points. Pre- and post-endoscopy mean visual analog scale scores to assess the expected level of discomfort during endoscopy were not statistically different. Forty-four patients (73.3%) indicated their willingness to undergo repeat non-sedated endoscopy in the future if required. Binary logistic regression analysis identified young age, male gender, and long duration of procedure as significant factors for unwillingness to undergo repeat non-sedated endoscopy.

Non-sedated endoscopy is a feasible, safe, and fast office procedure and seems well tolerated by most patients.