title: Pretreatment methods in transnasal endoscopy.
abstract: OBJECTIVE
  Transnasal endoscopy is generally recognized as a less painful endoscopic procedure. The pretreatment procedure, particularly anesthesia of the nasal cavities, is reported to be vitally important for alleviating pain.
  
  
  METHODS
  The study comprised 120 patients treated by the spray method, 203 treated by the stick method, and 100 treated by the stick + pharyngeal anesthesia method between April 2005 and March 2009. We investigated the pain levels using three pretreatment methods based on the results of a questionnaire.
  
  
  RESULTS
  Pain at the time of insertion of an endoscope into the nasal cavity was common in all patients. It was experienced in 58.3%, 53.7% and 41.0% of patients treated by the spray, stick and stick + pharyngeal anesthesia methods, respectively. The pain was alleviated by the stick + pharyngeal anesthesia method significantly (p=0.022). Patients who did not experience any pain at the time of the endoscopic examination were 15.0%, 16.2% and 18.0%, respectively, with no significant differences.
  
  
  CONCLUSIONS
  The least painful pretreatment procedure in the endoscopic examination was the stick + pharyngeal anesthesia method.
authors.affiliation: Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Tokyo, Japan. junnki@dg.mbn.or.jp
authors.forename: Junichi
authors.initials: J
authors.lastname: Iwamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizokami
authors.forename: Koichi
authors.initials: K
authors.lastname: Shimokobe
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirayama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Saito
authors.forename: Akira
authors.initials: A
authors.lastname: Honda
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzaki
mesh_terms: D000328:Adult; D000368:Aged; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity