Prospective comparison of nasal versus oral insertion of a thin video endoscope in healthy volunteers.
OBJECTIVE
Attempts have been made to improve patient's tolerance of upper gastrointestinal endoscopy and to decrease the need for sedation, using thinner endoscopes and a nasal introduction route. We prospectively compared the oral and nasal routes in volunteers, using a thin prototype video endoscope.


METHODS
Ten healthy volunteers underwent two upper gastrointestinal endoscopies in a random order on two different days, with the procedure being carried out by a single experienced endoscopist. Parameters assessed were the tolerance of scope insertion and the assessment of the entire procedure (0-10 scale), the method of insertion preferred by the volunteers, the completeness of the examination (assessed by an independent endoscopist), and the time required for the procedure.


RESULTS
In one patient, nasal insertion failed, and she was excluded from further analysis. The insertion of the scope was easier via the oral route, as reflected in a shorter examination time (mean 165 vs. 210 seconds, p = 0.017) and patients' tolerance for the scope insertion (mean score: 8 for oral vs. 4 for nasal route; p = 0.03). On the other hand, gagging occurred more frequently during oral endoscopy (6/9 vs 1/9, p = 0.05). Three of the volunteers in each case preferred the oral or the nasal route, and three were not decided, in case of a repeated endoscopy. Similarly, the overall tolerance for the procedure did not between the two groups.


CONCLUSIONS
Thin-diameter gastroscopes seem to improve patient's tolerance. In this small study in volunteers, nasal introduction showed no overall benefit over oral introduction. Modifications of the scope to achieve better nasal passage are necessary.
Roy
J F
JF
Dept. of Hepatology and Gastroenterology, Arnault Tzanck Institute, Saint Laurent du Var, France.
Duforest
D
D
Marek
T A
TA
D000328:Adult; D004582:Electronics, Medical; D004867:Equipment Design; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009666:Nose; D017060:Patient Satisfaction; D011446:Prospective Studies
D006993:Hypnotics and Sedatives