Comparison of procedural sequences in same‐day painless bidirectional endoscopy: Single‐center, prospective, randomized study. Issue 3 (30th March 2017)

• Record Type: Journal Article
• Authors: Cao, Yan; Yang, Jun; Li, Jiao; Ao, Xin; Zhang, Kai‐Yuan; Shen, Xiao‐Chun; Chen, Dong‐Feng; Lan, Chun‐Hui
• Is Part Of: Digestive endoscopy. Volume 29:Issue 3(2017)
• Page Start: 330
• Page End: 337
• Publication Date: 2017-03-30
• Subjects: cardiopulmonary response -- colonoscopy -- esophagogastroduodenoscopy -- same‐day bidirectional endoscopy -- sequence; Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12847
• Languages: English
• ISSNs: 0915-5635

Abstract

Abstract : Background and Aim: To compare the efficacy and safety of esophagogastroduodenoscopy (EGD)‐colonoscopy and colonoscopy‐EGD sequences for patients subjected to same‐day bidirectional endoscopy under remifentanil and propofol sedation. Methods: A total of 209 eligible outpatients scheduled for diagnostic same‐day bidirectional endoscopy between 16 February 2016 and 30 April 2016 were randomly assigned to the EGD‐colonoscopy ( n = 106) and colonoscopy‐EGD ( n = 103) sequence groups. Primary endpoint was total dose of propofol required for the procedure. Secondary endpoints included duration of endoscopy, patient satisfaction, adverse effects, endoscopy findings, and cardiopulmonary responses of the patients. Results: Patients in the two groups were similar in terms of demographic and clinical data ( P > 0.05). EGD‐colonoscopy sequence group had lesser requirement of propofol for sedation ( P < 0.05), faster recovery ( P < 0.001), and lesser influence on mean arterial pressure (MAP) during the endoscopy ( P < 0.05). Duration of EGD and colonoscopy, patient satisfaction, adverse effects, and pathological findings did not differ between the two groups. Conclusions: The EGD‐colonoscopy sequence may be considered the preferred sequence for same‐day bidirectional endoscopy as a result of less cardiovascular stress, lessened need for sedation with propofol, and faster recovery.