Gastrointestinal endoscopy
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Gastrointest. Endosc. · Mar 2000
Randomized Controlled Trial Multicenter Study Clinical TrialA randomized, controlled trial of transcutaneous carbon dioxide monitoring during ERCP.
Pulse oximetry, used to monitor oxygen saturation during endoscopy, does not directly measure hypoventilation. Study goals were to determine whether transcutaneous carbon dioxide (PtcCO(2)) monitoring during endoscopic retrograde cholangiopancreatography (ERCP) prevents severe hypoventilation and to assess the accuracy of clinical observation and pulse oximetry in detecting hypoventilation. ⋯ Carbon dioxide retention during ERCP is not reliably detected by clinical observation or by pulse oximetry in patients receiving supplemental oxygen. The addition of PtcCO(2) monitoring prevents severe carbon dioxide retention more effectively than intensive clinical monitoring and pulse oximetry alone. The clinical relevancy of this observation needs to be determined in an appropriately designed outcome study.
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Gastrointest. Endosc. · Mar 2000
Randomized Controlled Trial Clinical TrialDisposable versus reusable biopsy forceps: a prospective cost evaluation.
There is growing advocacy for the use of disposable medical accessories to reduce the risks of infection transmission. Their purchase costs can, however, be considered as prohibitive in an endoscopy unit operating under a cost-containment program. We therefore compared the costs of reusable and disposable biopsy forceps. ⋯ Total purchase and reprocessing costs for reusable biopsy forceps were 25% of those of disposable devices. The use of disposable biopsy forceps would have led to a yearly extra cost of $78,377 in the operation of our endoscopy unit.
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Gastrointest. Endosc. · Mar 2000
Randomized Controlled Trial Clinical TrialNitrous oxide for colonoscopy: a randomized controlled study.
Intravenous sedation/analgesia for colonoscopy is accompanied with certain risks and postprocedure drowsiness. We sought to determine whether inhaled nitrous oxide (Entonox: 50% nitrous oxide, 50% oxygen) provides adequate analgesia for colonoscopy and the impact of this agent on recovery. ⋯ Entonox is less effective than midazolam with meperidine for colonoscopy but is acceptable in many patients and allows faster recovery.
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Gastrointest. Endosc. · Dec 1999
Randomized Controlled Trial Clinical TrialEndoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding: a randomized controlled trial.
Many patients with upper gastrointestinal (GI) bleeding have a benign outcome and could receive less intensive and costly care if accurately identified. We sought to determine whether early endoscopy performed shortly after admission in the emergency department could significantly reduce the health care use and costs of caring for patients with nonvariceal upper GI bleeding without adversely affecting the clinical outcome. ⋯ Early endoscopy performed shortly after admission in the emergency department safely triaged 46% of patients with nonvariceal upper GI bleeding to outpatient care, which significantly reduced hospital stay and costs.
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Gastrointest. Endosc. · Dec 1999
Randomized Controlled Trial Comparative Study Clinical TrialSelective cannulation of the common bile duct: a prospective randomized trial comparing standard catheters with sphincterotomes.
Current recommendations for the use of standard catheters or sphincterotomes for the initial attempt at selective common bile duct cannulation have been made in the absence of prospective comparative data. ⋯ The use of standard/wire-guided sphincterotome was superior to that of standard catheter for the initial attempt at cannulation of the common bile duct. The number of attempts required may bear clinical significance with regard to the development of post-ERCP pancreatitis and warrants further study.