The researchers assessed sedation use for routine gastroscopy, in a single endoscopy unit, between 1989 and 1998, and reported their findings in February's Alimentary Pharmacology and Therapeutics.
9795 consecutive adults (mean age 56 years, range 18-100 years; 4512 females) who had undergone a gastroscopy between 1989 and 1998 were studied retrospectively. Clinical, pharmacological, and endoscopic data were retrieved from a computerized database.
|Patient sedation rates|
Therapeutic endoscopy - Constant
In-patient diagnostic exams - Constant
Out-patient diagnostic exams - Decreased by 54%
|Alimentary Pharmacology and Therapeutics|
The team found that over the 10-year study period, the sedation rate remained constant for patients undergoing therapeutic endoscopy and those undergoing in-patient diagnostic examinations.
In contrast, the sedation rate for out-patient diagnostic endoscopy decreased by 54 per cent - from a high of 70 per cent in 1990 - to 32 per cent in 1998. Logistic regression analysis showed that the decline in sedation use was greater in females than males and in procedures performed by non-consultant compared to consultant staff.
Dr H. Mulcahy from the Department of Gastroenterology, King's College Hospital, London, said on behalf of the group, "If our results form part of a national trend, they will have important implications. These will include cardiopulmonary monitoring strategies, recovery-room practices, and for complication rates due to the use of sedation for upper gastrointestinal endoscopy."