In the United States, upper gastrointestinal endoscopy is usually performed using intravenous sedation.
However, sedation increases the rate of both complications and costs of endoscopy.
Unsedated esophagogastroduodenoscopy (EGD) using conventional 8–11-mm endoscopes is an alternative to sedated endoscopy. This is generally perceived as unacceptable to many patients.
Unsedated EGD using ultrathin 5–6-mm endoscopes is better tolerated.
|There was no difference in overall patient satisfaction.|
In this study, physicians compared unsedated ultrathin EGD (UT-EGD) with sedated conventional EGD (C-EGD).
The team randomized 80 patients, scheduled to undergo elective outpatient EGD, to either unsedated UT-EGD or sedated C-EGD.
The physicians determined that baseline characteristics of patients in the 2 groups were similar.
They identified no significant differences in overall patient satisfaction or willingness to repeat the procedure between the 2 study groups.
There was a significant difference in median total procedure time.
The team calculated that the mean total procedure cost was $512.4 for sedated C-EGD and $328.6 for unsedated UT-EGD.
Dr Ruel Garcia's team concluded, "Patients undergoing unsedated UT-EGD are as satisfied as patients undergoing sedated C-EGD.
"[Patients] are just as willing to repeat an unsedated UT-EGD".
"Unsedated UT-EGD was also faster, less costly, and may allow greater accessibility to this procedure".