Endoscopy
-
Randomized Controlled Trial Multicenter Study
Carbon dioxide insufflation improves intubation depth in double-balloon enteroscopy: a randomized, controlled, double-blind trial.
Double-balloon enteroscopy (DBE) has been proven effective for deep intubation of the small bowel. However, intubation depth is limited by distention of the small bowel due to air insufflation during the procedure. The present trial investigated whether carbon dioxide (CO (2)) instead of standard air insufflation would improve intubation depth during DBE, as well as reduce postprocedure pain. ⋯ CO (2) insufflation significantly extended intubation depth in DBE. CO (2) insufflation also reduces patient discomfort. CO (2) insufflation may lead to a higher diagnostic and therapeutic yield of DBE, with reduced patient discomfort.
-
Randomized Controlled Trial Comparative Study
A randomized controlled trial on use of propofol alone versus propofol with midazolam, ketamine, and pentazocine "sedato-analgesic cocktail" for sedation during ERCP.
Endoscopic retrograde cholangiopancreatography (ERCP) requires adequate patient sedation in order to carry out the procedure successfully. Propofol sedation is being increasingly used during ERCP. There are limited data to evaluate the efficacy of synergistic agents with propofol for sedation during ERCP. The aims of the current study were: (i) to compare patient sedation and tolerance during ERCP using either propofol alone or a "sedato-analgesic cocktail" for induction, along with propofol for maintenance, and (ii) to prospectively compare complications related to both sedation regimens. ⋯ During ERCP, propofol with a sedato-analgesic cocktail for induction results in improved patient tolerance compared with propofol alone, particularly in younger patients. Generalizations from this study to the Western world and to different cultural groups require further study.
-
Randomized Controlled Trial
Impact of an information video before colonoscopy on patient satisfaction and anxiety - a randomized trial.
Anxiety before colonoscopy may have adverse consequences and increase requirements for sedation and analgesics. We aimed to examine the effects of adding an information video to our usual preprocedural information. ⋯ An information video shown to patients preparing for colonoscopy had no impact on tolerability or anxiety. Colonoscopy is less tolerable and more painful for women and this is probably related to a higher degree of anxiety. Endoscopy personnel should be aware of these gender differences and adjust information and medication accordingly.
-
Randomized Controlled Trial Comparative Study
The effect of sedation on the quality of upper gastrointestinal endoscopy: an investigator-blinded, randomized study comparing propofol with midazolam.
Sedation with propofol is associated with a high acceptance rate in upper gastrointestinal endoscopy. So far, however, there are no valid data on whether the use of propofol can increase the general quality of the endoscopic examination. ⋯ Sedation with propofol might increase the quality of upper endoscopy. This finding may have a significant impact on the selection of the type of sedation, not only in terms of increasing patients' acceptance of the procedure, but also for improving the diagnostic accuracy of upper gastrointestinal endoscopy.
-
Randomized Controlled Trial Comparative Study
Carbon dioxide insufflation for more comfortable endoscopic retrograde cholangiopancreatography: a randomized, controlled, double-blind trial.
The effect on abdominal pain of using carbon dioxide (CO2) for insufflation during endoscopic retrograde cholangiopancreatography (ERCP) has not been investigated. The present study aimed to compare CO2 insufflation with standard air insufflation with respect to the pain experienced during and after ERCP. In addition, we investigated the effect of CO2 insufflation on the partial pressure of CO2 (Pco2). ⋯ Carbon dioxide insufflation during ERCP significantly reduces postprocedural abdominal pain. No side effects were observed. Carbon dioxide should be the standard gas used for insufflation in ERCP.