Ergonomic wedge pillow to reduce neck pain after prone ERCP; a randomized, controlled study

Area of Science:

• Gastroenterology
• Medical Devices
• Patient Comfort

Background:

• Prone positioning during endoscopic retrograde cholangiopancreatography (ERCP) is associated with increased cervical spine stress and prolonged muscle stretching, leading to post-procedure neck pain.
• Evaluating novel interventions to mitigate discomfort and improve procedural outcomes in ERCP is crucial.

Purpose of the Study:

• To assess the efficacy and patient satisfaction of an ergonomic wedge pillow designed to reduce neck pain during prone ERCP.
• To evaluate the impact of the pillow on procedural difficulty and endoscopist satisfaction.

Main Methods:

• A randomized controlled trial involving 256 patients undergoing prone ERCP.
• Patients were allocated to either a study group (ergonomic pillow) or a control group.
• Neck pain, scope intubation difficulty, and shoulder lifting requirements were assessed by blinded evaluators and endoscopists.

Main Results:

• The study group experienced significantly lower prevalence of post-procedural neck pain at 1 day (19% vs. 30%, p=0.040), particularly moderate-to-severe pain (4% vs. 11%, p=0.032).
• Reduced difficulty in scope intubation and less need for patient shoulder lifting were observed in the pillow group (p=0.002).
• Endoscopists reported significantly higher satisfaction scores in the study group (9.6 vs. 8.9, p<0.001).

Conclusions:

• The ergonomic wedge pillow effectively reduced moderate-to-severe neck pain one day after prone ERCP.
• The pillow improved procedural ease by decreasing scope intubation difficulty and the need for shoulder lifting.
• The intervention led to higher endoscopist satisfaction, indicating its clinical utility.