RT Journal Article
SR Electronic
T1 Acceptability of oesophagogastroduodenoscopy without intravenous sedation: patients’ versus endoscopist’s perception with special reference to older patients
JF Postgraduate Medical Journal
JO Postgrad Med J
FD The Fellowship of Postgraduate Medicine
SP 650
OP 651
DO 10.1136/pmj.79.937.650
VO 79
IS 937
A1 B R Thanvi
A1 S K Munshi
A1 N Vijayakumar
A1 N Taub
A1 T C N Lo
YR 2003
UL http://pmj.bmj.com/content/79/937/650.abstract
AB Background::Unsedated oesophagogastroduodenoscopy (OGD) is considered by most endoscopists to be a quick, safe, and well tolerated procedure. Older patients are said to tolerate it better than younger patients. However, patients’ perception of the discomfort for the unsedated OGD has not been well studied. Objective::This study was undertaken to compare (1) patients’ perception of discomfort with the endoscopist’s perception of patients’ discomfort for the unsedated OGD, (2) tolerability between older (⩾75 years) and younger (<75 years) patients. Design and subjects::A total of 130 consecutive patients attending a day case endoscopy unit were recruited for the study. The patients and endoscopist recorded their assessment using a visual analogue scale (VAS). The results were analysed using non-parametric tests. Thirty patients were excluded from the study based on exclusion criteria. Sixty three (57%) patients were aged ⩾75 years and 37 (43%) were <75 years. Results::A significant difference was noted between patients’ perception of the discomfort and the endoscopist’s assessment of the patient’s discomfort as suggested by the overall higher VAS scores for patients (median 4.9, SD 2.6) than those of the endoscopist (median 2.2, SD 1.2), giving a significant difference in median VAS score of 3.4 (p<0.001). Older and younger patients had similar scores, with median (SD) VAS scores of 4.8 (2.5) for ⩾75 years and 4.9 (2.8) for <75 years. The endoscopist’s median scores for these two groups were 2.2 (1.2) and 2.1 (1.3), respectively. Conclusions::Patients’ discomfort during OGD performed without sedation was greatly underestimated by the endoscopist. There was no significant difference in acceptability between old and the young patients.