An Instrument to Predict Endoscopy Tolerance: A Prospective Randomized Study
- 87 Downloads
Our purpose in this study was to determine if the use of an instrument developed by our group to direct sedation choice improves patient satisfaction with endoscopy sedation compared to standard sedation practice. After 200 enrollments, data were available for 194 patients who completed the study. There were nine cases of dissatisfaction: five (5%) in the control group and four (4%) in the intervention group (P = 0.78). The 95% confidence intervals (1%–10%) were almost identical, indicating no difference between groups. The study was stopped after an interim analysis showed no significant difference in satisfaction between the groups. This could have been because the assumption that patients with increased risk of dissatisfaction do better with deeper sedation is incorrect. Another explanation could be the increased awareness of the value of benzodiazepines in endoscopy. Consistent with our findings, nervousness rather than pain predicted dissatisfaction, and the optimal use of anxiolytics with amnesic properties may be comparable to that of propofol.
KeywordsEndoscopy Outcome Sedation Satisfaction
This work was supported, in part, by a generous 2-year grant from the American Society for Gastrointestinal Endoscopy (ASGE). Special thanks go to Dr. Edwin A. Bowe, Jr., and the faculty of the Anesthesia Department, University of Kentucky, for their invaluable collaboration, which made this study possible. We thank our study coordinators, Sylvia Nicholson and Sarah Turner, for their hard work.
- 1.Everhart JE (1994) Overview. In: Digestive diseases in the United States: epidemiology and impact. NIH Publication 94-1447. Everhart JE (ed). U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Bethesda, MD, pp 3–53Google Scholar
- 5.Ciriza C, Garcia L, Fernadez A, Diez A, Delgado M, San Sebastian AI (2001) Sedation for gastrointestinal endoscopy. Analysis of tolerance and complications. Rev Esp Enferm Dig 93(9):587–597Google Scholar
- 6.Schutz Sm, Lee LG, Scmitt Cm, Almon M, Baillie J (1994) Clues to patient dissatisfaction with conscious sedation for colonoscopy. Am J Gastroenterol 98(9):1476–1483Google Scholar
- 8.Ware JE, Snyder MK, Wright WR (1998) Development and validation of scale to measure patient satisfaction with health care services. Vol 1, Part B. National Technical Information, Springfield, VAGoogle Scholar
- 10.Greenley JR, Young TB, Schoenheor RA (1982) Psychological distress and patient satisfaction. Med Care 20(4):373–385Google Scholar