[Anxiety and stress reaction and its management in ambulatory gastrointestinal endoscopy: is premedication justified?]

This study is a contribution to the the question, whether the fear of ambulant gastrointestinal endoscopy generally justifies an anxiolytic premedication. Intensity of the stress reaction (subjective stress reactions, cardiovascular and endocrinological stress parameters), situation-specific determinants and coping behavior were analyzed one week and immediately before and immediately after the diagnostic procedure in N = 135 patients. The results showed significant effects of the procedure on subjective, cardiovascular and endocrinological stress parameters. Furthermore, other stress-eliciting conditions like former experiences with the procedure, behavior of the doctor and the assisting staff, organisational conditions could be identified. All in all, for most of the patients the endoscopy examination was less aversive as reported in the literature. According to our results, the amount of fear and stress reactions cannot justify the risks of an anxiolytic premedication. Only for a small group of patients (about 25%) the question of premedication should be proved individually. These patients can be identified by a questionnaire or by a rough screening of the anxiety level by behavior observation during a preparating anamnesis.