Published in:
01-06-2013 | Original Article
Comparison of Nitrous Oxide to No Sedation and Deep Sedation for Diagnostic Upper Gastrointestinal Endoscopy
Published in: Journal of Gastrointestinal Surgery | Issue 6/2013
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Background
In China, great efforts are dedicated to reducing discomfort and minimizing undesirable complications for patients undergoing upper gastrointestinal (UGI) endoscopy.
Methods
This study was conducted to compare the diagnostic accuracy, safety, complications, and patient and examiner satisfaction for different sedation approaches. We carried out a prospective and randomized study on 450 patients undergoing diagnostic UGI endoscopy. During the procedure, patients received N2O by inhalation; an intravenous mixture of midazolam, remifentanil, and propofol; or no sedative. The cardiorespiratory functions, procedure duration, recovery time, length of hospital stay, complications, and ratings of patient and examiner satisfaction were recorded.
Results
Compared to those deeply sedated, patients inhaling N2O had comparable diagnostic accuracy, significantly shorter procedure and recovery times, a lower risk of cardiorespiratory distress, but a higher number of minor complications and post-procedure mental issues. The procedural satisfaction ratings were highest for those receiving deep sedation; fewer patients reported willingness to reconsider N2O for a future upper GI endoscopy. The lowest satisfaction rating was given by those who received no sedation.
Conclusions
Multiple factors should be considered before selecting N2O as the sedative for diagnostic UGI endoscopy, including the patient’s economic status, potential risk of cardiorespiratory distress, and sensitivity to potential adverse effects of N2O administration.