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Less tachycardia during transnasal versus conventional gastroscopy.

Anders U Neuenschwander¹, Merete Christensen, Svend Schulze

¹Kirurgisk Afdeling, Hillerød Hospital, 3400 Hillerød, Denmark. aun@hih.regionh.dk

Danish Medical Journal

|June 9, 2012

Summary

Transnasal endoscopy showed a lower stress response with reduced pulse rates compared to conventional gastroscopy. However, it was technically inferior and offered no significant patient comfort benefits beyond less gagging.

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Area of Science:

Gastroenterology
Endoscopy
Cardiopulmonary Physiology

Background:

Transnasal endoscopy is generally well-tolerated.
Previous studies have not detailed the physiological benefits of transnasal endoscopy compared to conventional gastroscopy.

Purpose of the Study:

To evaluate cardiopulmonary features, patient tolerance, and endoscopist assessment of transnasal versus conventional endoscopy.
To compare physiological stress responses between the two endoscopic approaches.

Main Methods:

A randomized study comparing transoral (50 patients) and transnasal (48 patients) endoscopy.
Monitoring of pulse rate, oxygen saturation, patient tolerance, and endoscopist evaluation.

Main Results:

Transnasal gastroscopy had a 77% success rate, limited by nasal stenosis.
Lower per- and post-procedure pulse rates were observed in the transnasal group (p = 0.04, p = 0.02).
Similar procedural discomfort but significantly less gagging (p < 0.01) in the transnasal group.

Conclusions:

Transnasal gastroscopy was technically inferior to conventional methods.
No significant patient comfort benefits were found, except for reduced gagging.
Lower pulse rates suggest a reduced stress response, though clinical relevance requires further investigation.