title: Safety and acceptance of non-sedated upper gastrointestinal endoscopy: a prospective observational study.
abstract: BACKGROUND
  The study was conducted to assess the patient acceptability of non-sedated upper gastrointestinal (GI) endoscopy and to study cardiorespiratory changes during the procedure.
  
  
  METHODS
  This study was conducted in the outpatient endoscopy room of Department of Surgery of a teaching tertiary-care hospital in North India. The patients underwent diagnostic GI endoscopy under topical pharyngeal anesthesia using 5% lidocaine. No sedation was used. Pulse rate (PR), respiratory rate (RR), oxygen saturation (SpO(2)), and mean blood pressure (BP) were recorded immediately prior to endoscopy, during endoscopy, and 5, 15, and 30 minutes after endoscopy. Using a 10-point Likert scale, all the patients were asked to record their expected discomfort for the endoscopy as a pre-test score and their actual level of discomfort during endoscopy as a post-test score. Patients were also asked about whether they would opt for non-sedated upper GI endoscopy again in the future if required.
  
  
  RESULTS
  Sixty patients underwent diagnostic upper GI endoscopy during the study period. Post hoc tests using Bonferroni's correction revealed that mean PR, RR, and mean BP changed significantly during endoscopy. However, these parameters normalized at 30 minutes following endoscopy. Mean SpO(2) did not differ significantly at the different time points. Pre- and post-endoscopy mean visual analog scale scores to assess the expected level of discomfort during endoscopy were not statistically different. Forty-four patients (73.3%) indicated their willingness to undergo repeat non-sedated endoscopy in the future if required. Binary logistic regression analysis identified young age, male gender, and long duration of procedure as significant factors for unwillingness to undergo repeat non-sedated endoscopy.
  
  
  CONCLUSIONS
  Non-sedated endoscopy is a feasible, safe, and fast office procedure and seems well tolerated by most patients.
authors.affiliation: Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India. dr.pankajgarg@gmail.com
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Garg
authors.forename: Abhishek Pratap
authors.initials: AP
authors.lastname: Singh
authors.forename: Bhupendra Kumar
authors.initials: BK
authors.lastname: Jain
authors.forename: Amit
authors.initials: A
authors.lastname: Bansal
authors.forename: Debajyoti
authors.initials: D
authors.lastname: Mohanty
authors.forename: Vivek
authors.initials: V
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage; D016145:Endoscopy, Digestive System / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007194:India; D008012:Lidocaine / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine