title: Comfort, safety and quality of upper gastrointestinal endoscopy after 2 hours fasting: a randomized controlled trial.
abstract: BACKGROUND
  Upper gastrointestinal endoscopy has been performed after fasting 8 or more hours, which can be harmful to the patients. We assessed comfort, safety and quality of endoscopy under moderate sedation after 2 hours fasting for clear liquids.
  
  
  METHODS
  In this clinical trial, patients referred for elective endoscopy were randomly assigned to a fasting period of 8 hours (F8) or a shorter fasting (F2), in which 200 ml of clear liquids were ingested 2 hours before the procedure. Endoscopists blinded to patients fasting status carried out the endoscopies. Comfort was rated by the patients, whereas safety and quality were determined by the endoscopists.
  
  
  RESULTS
  Ninety-eight patients were studied (aging 48.5 ± 16.5 years, 60% women): 50 patients (51%) in F2 and 48 in F8. Comfort was higher in F2 than F8 in regard to anxiety (8% vs. 25%; P = 0.029), general discomfort (18% vs. 42%; P = 0.010), hunger (44% vs. 67%; P = 0.024), and weakness (22% vs. 42%; P = 0.034). Regurgitation of gastric contents into the esophagus after endoscopic intubation did not differ between F2 and F8 (26% vs. 19%; P = 0.471). There was no case of pulmonary aspiration. Gastric mucosal visibility was normal in most patients either in F2 or F8 (96% vs. 98%; P = 0.999).
  
  
  CONCLUSIONS
  Elective upper GI endoscopy after 2 hours fasting for clear liquids was more comfortable and equally safe compared to conventional fasting. This preparation might be cautiously applied for patients in regular clinical conditions referred for elective endoscopy.
  
  
  BACKGROUND
  SAMMPRIS ClinicalTrial.gov number, NCT01492296.
authors.forename: Angélica Terezinha
authors.initials: AT
authors.lastname: Koeppe
authors.forename: Marcio
authors.initials: M
authors.lastname: Lubini
authors.forename: Nilton Maiolini
authors.initials: NM
authors.lastname: Bonadeo
authors.forename: Iran
authors.initials: I
authors.lastname: Moraes
authors.affiliation: Programa de Pós-Graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre-RS, Brazil. fernandofornari@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fornari
mesh_terms: D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures; D016145:Endoscopy, Digestive System / Q000379:methods*; D005215:Fasting; D005260:Female; D006801:Humans; D057045:Laryngopharyngeal Reflux; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016037:Single-Blind Method; D013997:Time Factors