Transnasal esophagogastroduodenoscopy with a small-caliber endoscope is well tolerated by patients.
However, the effect of this procedure on cardiopulmonary function has not been fully investigated.
Dr Yagi and colleagues from Japan conducted a prospective, randomized study.
The research team investigated the effect of transnasal esophagogastroduodenoscopy.
The team compared this with transoral esophagogastroduodenoscopy on cardiopulmonary function.
|6% examined by transnasal esophagogastroduodenoscopy had epistaxis|
The study involved 450 patients referred for diagnostic esophagogastroduodenoscopy.
The team randomized 150 patients to 1 of 3 types of unsedated esophagogastroduodenoscopy.
Group 1 included transnasal esophagogastroduodenoscopy using a small-caliber endoscope.
Patients in Group 2 had transoral esophagogastroduodenoscopy using the same small-caliber endoscope.
Group 3 included transoral esophagogastroduodenoscopy using a conventional endoscope.
Systolic and diastolic blood pressure, pulse rate, and arterial oxygen saturation were monitored before, and 2, 4 and 6 minutes after intubation.
Systolic and diastolic blood pressure was also measured just after endoscope extubation.
Gagging episodes were also counted, to determine tolerance.
The team reported that it was not possible to perform transnasal esophagogastroduodenoscopy in 8% of patients.
A small amount of epistaxis was observed in 6% of patients who were examined successfully by transnasal esophagogastroduodenoscopy.
The researchers found that systolic and diastolic blood pressure, pulse rate, rate-pressure product were greater in Group 3 than in the other 2 groups at each point.
The drop in arterial oxygen saturation in Group 3 was also greater than in Group 1 and Group 2 at each time point.
The researchers observed that in Group1, these parameters were significantly lower than those in the Group 2 at 2 minutes after intubation.
Of the 3 groups, the team noted that the number of gagging episodes was significantly lower in Group1.
Dr Yagi's team commented, “Transnasal esophagogastroduodenoscopy is safer than transoral esophagogastroduodenoscopy as it is associated with fewer adverse effects on cardiopulmonary function and is better tolerated by patients.”