title: Catheter-free method is sufficient for preparation for transnasal endoscopy: randomized controlled trial.
abstract: OBJECTIVE
  Although transnasal endoscopy (TNE) is generally a comfortable and safe procedure, it has some disadvantages, such as complicated preprocessing and occasional repulsion reaction during catheterization. In an attempt to simplify the preprocessing method, the efficacy of a catheter-free method in which a catheter is not inserted into the nasal cavity was assessed.
  
  
  METHODS
  The present study was a prospective, open-label, single-center, randomized controlled study with parallel assignment allocation 1:1. Between March 2009 and August 2009, a total of 93 TNE-naïve patients were enrolled and randomized. Patients were prospectively randomized into two groups (catheter-free vs catheter-insertion method). Patients who prepared according to the catheter-free method and who were unsuccessful underwent the catheter-insertion method. Clinical characteristics, success rate, complications, vital signs, acceptability, and tolerability were assessed and compared.
  
  
  RESULTS
  Success rates of the catheter-free and catheter-insertion methods were 88% (n=44) and 88% (n=38) (P>0.05), respectively. Causes of failure in the catheter-free method included severe rhinalgia (n=1, 2%) and narrowing of the nasal cavity (n=5, 10%). Causes of failure in the catheter-insertion method included narrowing of the nasal cavity (n=5, 11%). Six patients whose TNE failed with the catheter-free method also experienced failed TNE with the catheter-insertion method. There were no statistical differences in vital signs, acceptability, and tolerability.
  
  
  CONCLUSIONS
  The catheter-free method is sufficient for preparation for TNE. The success rate of TNE depends more on the structure of the nasal cavity than the preprocessing method.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Yong Sub
authors.initials: YS
authors.lastname: Lee
authors.forename: Chang Seok
authors.initials: CS
authors.lastname: Bang
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.forename: Yoon Hyeong
authors.initials: YH
authors.lastname: Lee
authors.forename: Young Lim
authors.initials: YL
authors.lastname: Ham
authors.forename: Hotaik
authors.initials: H
authors.lastname: Sung
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Ko
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Kim
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Min Sang
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D057785:Catheters; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D056910:Republic of Korea
chemical_list: D008012:Lidocaine
keywords: anesthesia; catheter; gastrointestinal endoscope; lidocaine; nasal spray