title: Acceptability of oesophagogastroduodenoscopy without intravenous sedation: patients' versus endoscopist's perception with special reference to older patients.
abstract: 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 (> or =75 years) and younger (<75 years) patients.
  
  
  METHODS
  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 > or =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 > or =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.
authors.affiliation: Department of Medicine for the Elderly, Leicester General Hospital, University Hospitals of Leicester NHS Trust, UK. bthanvi@hotmail.com
authors.forename: B R
authors.initials: BR
authors.lastname: Thanvi
authors.forename: S K
authors.initials: SK
authors.lastname: Munshi
authors.forename: N
authors.initials: N
authors.lastname: Vijayakumar
authors.forename: N
authors.initials: N
authors.lastname: Taub
authors.forename: T C N
authors.initials: TC
authors.lastname: Lo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000379:methods* / Q000523:psychology; D016145:Endoscopy, Digestive System / Q000379:methods* / Q000523:psychology; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception