Comparison of the cardiorespiratory effects and tolerability of sedated transoral and unsedated nasal upper gastrointestinal endoscopy

Motoi Takeuchi, Yoshinori Igarashi, Shigeru Nakano, Kaoru Domon, Ai Fujimoto, Takafumi Otsuka, Yoshinori Fujitsuka, Yoshinori Kikuchi, Yasukiyo Sumino

Research output: Contribution to journalArticle

Abstract

Objective: To compare the effects of sedated transoral and unsedated nasal upper gastrointestinal endoscopy on cardiorespiratory parameters and tolerability. Methods: The study population included 696 patients who underwent unsedated nasal upper gastrointestinal endoscopy in our hospital. Of the 696 patients, data on systolic blood pressure, heart rate, and arterial oxygen saturation before and during the procedure were available for 238 patients, who were compared with 113 patients (mean age 61.8 years, male/female ratio 1:1) who underwent sedated transoral upper gastrointestinal (GI) endoscopy. The degree of pain experienced by the patients was evaluated by using a 4-point pain scale and compared between the 2 groups. Results: As compared with preprocedure (baseline) values, heart rate was significantly higher during the procedure in both groups (p<0.01 for both); however, values were significantly higher in the sedated transoral upper GI endoscopy group than in the unsedated nasal upper GI endoscopy group (p<0.01, p<0.001). Systolic blood pressure was significantly higher than baseline when the scope tip was positioned at the esophagogastric junction, and gradually declined thereafter. Rate-pressure product was significantly higher in the sedated transoral upper GI endoscopy group than in the other group when the scope tip was positioned at the esophagogastric junction and in the descending part of the duodenum, and after the procedure was completed (p<0.05 for all comparisons). Intraprocedural arterial oxygen saturation was significantiy lower in the sedated transoral upper GI endoscopy group than in the other group (p< 0.001). There was no significant difference in the degree of pain associated with the 2 procedures. Conclusions: Our results suggest that the adverse effect on cardiorespiratory function is greater with sedated transoral upper GI endoscopy than with unsedated nasal upper GI endoscopy.

Original languageEnglish
Pages (from-to)74-80
Number of pages7
JournalJournal of the Medical Society of Toho University
Volume58
Issue number2
Publication statusPublished - 2011 Mar 1

Keywords

  • Circulatory dynamics change
  • Nasal upper gastrointestinal endoscopy
  • Sedated transoral gastrointestinal endoscopy

ASJC Scopus subject areas

  • Medicine(all)

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    Takeuchi, M., Igarashi, Y., Nakano, S., Domon, K., Fujimoto, A., Otsuka, T., Fujitsuka, Y., Kikuchi, Y., & Sumino, Y. (2011). Comparison of the cardiorespiratory effects and tolerability of sedated transoral and unsedated nasal upper gastrointestinal endoscopy. Journal of the Medical Society of Toho University, 58(2), 74-80.