Gastrointestinal endoscopy
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Gastrointest. Endosc. · Sep 2018
Randomized Controlled Trial Comparative StudyA phase III study evaluating the efficacy and safety of remimazolam (CNS 7056) compared with placebo and midazolam in patients undergoing colonoscopy.
Remimazolam is an ultrashort-acting benzodiazepine. ⋯ Remimazolam can be administered safely under the supervision of endoscopists for outpatient colonoscopy, and it allows faster recovery of neuropsychiatric function compared with placebo (midazolam rescue) and midazolam. (Clinical trial registration number: NCT02290873.).
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Gastrointest. Endosc. · Jul 2018
Randomized Controlled Trial Comparative StudyEfficacy of anterior versus posterior per-oral endoscopic myotomy for treating achalasia: a randomized, prospective study.
Per-oral endoscopic myotomy (POEM) has been demonstrated to be safe and effective for treating achalasia. Two approaches-anterior myotomy and posterior myotomy-are used during POEM. However, little is known about the comparison between the 2 different approaches. The objective of the study is to compare the safety and short-term efficacy of the 2 approaches for treating achalasia. ⋯ The short-term treatment efficacy, manometry outcomes, and adverse events were comparable between the anterior and posterior myotomy groups. Large-scale studies with long-term follow-up are warranted for a more definitive conclusion. (Clinical trial registration number: ChiCTR-ICR-15007211.).
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Gastrointest. Endosc. · May 2018
Randomized Controlled Trial Comparative StudyContinued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.
Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients. ⋯ Endoscopists performing moderate sedation should continue midazolam rather than switching to diphenhydramine in patients who do not achieve adequate sedation with usual doses of midazolam and an opioid. (Clinical trial registration number: NCT01769586.).
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Gastrointest. Endosc. · Mar 2018
Randomized Controlled TrialImpact of patient audiovisual re-education via a smartphone on the quality of bowel preparation before colonoscopy: a single-blinded randomized study.
Education on preparation is essential for successful colonoscopy. This study aimed to evaluate the impact of audiovisual (AV) re-education via a smartphone on bowel preparation quality before colonoscopy. ⋯ AV re-education via smartphone was easy and convenient, and enhanced preparation quality, patient adherence to instructions, and patient satisfaction.
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Gastrointest. Endosc. · Mar 2018
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialEffect of left lateral tilt-down position on cecal intubation time: a 2-center, pragmatic, randomized controlled trial.
Colonoscopy insertion is technically challenging, time-consuming, and painful, especially for the sigmoid. Several pilot studies indicated that the (left) tilt-down position could facilitate the insertion procedure, but no formal trials have been published to demonstrate its efficacy. We performed this study to verify the benefits of the left lateral tilt-down position (LTDP) on the insertion process. ⋯ LTDP for colonoscopy insertion can reduce insertion time and pain, and potentially improves patients' acceptance of unsedated colonoscopy. (Clinical trial registration number: NCT02842489.).