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Anxiety and Salivary Cortisol Levels in Children Undergoing Esophago-Gastro-Duodenoscopy Under Sedation

Duygu Kara1, Nevzat Aykut Bayrak2, Burcu Volkan3

  • 1Department of Anesthesia, Erzurum Regional Training and Research Hospital, Erzurum.

Journal of Pediatric Gastroenterology and Nutrition
|September 1, 2018
PubMed

Insights

Childhood esophagogastroduodenoscopy (EGD) causes significant stress, indicated by elevated salivary cortisol levels (SCL) before the procedure. Higher anxiety levels correlate with increased sedation and longer procedure times, potentially leading to complications.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Anxiety Research
  • Endocrinology

Background:

  • Esophagogastroduodenoscopy (EGD) is a common procedure in children, often associated with significant fear and anxiety.
  • Cortisol, a key stress hormone, is known to increase in response to physiological stress.

Purpose of the Study:

  • To measure salivary cortisol levels (SCL) and anxiety in children undergoing EGD.
  • To evaluate the impact of SCL and anxiety on the EGD procedure and its associated parameters.

Main Methods:

  • Salivary cortisol levels (SCL) and anxiety scores (modified Yale Preoperative Anxiety Scale) were measured in pediatric patients undergoing EGD.
  • SCL was assessed at baseline, before EGD, and 2 hours post-procedure, with comparisons to healthy controls.
  • Procedure duration, sedation details, and propofol dosage were recorded.

Main Results:

  • Children undergoing EGD exhibited significantly higher SCL before the procedure compared to their baseline and post-procedure levels.
  • Pre-EGD SCL positively correlated with anxiety levels, propofol dose, and the duration of sedation, procedure, and recovery.
  • Higher anxiety levels were associated with increased propofol dosage and longer sedation/recovery times, with a negative correlation to patient age.

Conclusions:

  • Childhood EGD is a significant stressor, evidenced by elevated pre-procedural SCL.
  • Increased anxiety in pediatric patients undergoing EGD is linked to higher propofol requirements and extended procedural durations.
  • These findings suggest that managing anxiety is crucial to potentially mitigate procedural complications.
Abstract

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