Comparison of Procedural Sequence in Same-day Consecutive Bidirectional Endoscopy Using Moderate Sedation

Carter, Dan; Lahat, Adi; Papageorgiou, Neofytos; Goldstein, Sergey; Eliakim, Rami; Bardan, Eytan

doi:10.1097/mcg.0b013e3182a87e5f

Cited by 11 publications

(16 citation statements)

References 3 publications

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“…Similar to the findings of previous reports, the duration and rate of detection of pathological findings did not differ significantly between the groups . Furthermore, we also found that satisfaction of the endoscopist, anesthetist, and patient did not differ significantly between both groups.…”

Section: Discussionsupporting

confidence: 90%

“…A study by Carter et al . in 2014 showed no significant difference in the discomfort and satisfaction of patients during BDE, regardless of the procedural sequence …”

Section: Introductionmentioning

confidence: 91%

“…8 In contrast, in 2013, Choi et al found that the procedural sequence did not affect colonoscopy performance quality and that patients in the EGD-colonoscopy group experienced less subjective discomfort during EGD. 9 A study by Carter et al in 2014 showed no significant difference in the discomfort and satisfaction of patients during BDE, regardless of the procedural sequence. 10 Thus, the results from these different studies are conflicting, and the sample sizes of these studies were relatively small.…”

Section: Introductionmentioning

confidence: 98%

“…9 A study by Carter et al in 2014 showed no significant difference in the discomfort and satisfaction of patients during BDE, regardless of the procedural sequence. 10 Thus, the results from these different studies are conflicting, and the sample sizes of these studies were relatively small. Additionally, there is a lack of data on the effects of routine sedation and endoscopic procedures on cardiorespiratory parameters of patients subjected to BDE.…”

Section: Introductionmentioning

confidence: 98%

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Comparison of procedural sequences in same‐day painless bidirectional endoscopy: Single‐center, prospective, randomized study

Cao

Yang

et al. 2017

Digestive Endoscopy

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Background and Aim: To compare the efficacy and safety of esophagogastroduodenoscopy (EGD)-colonoscopy and colonoscopy-EGD sequences for patients subjected to same-day bidirectional endoscopy under remifentanil and propofol sedation.Methods: A total of 209 eligible outpatients scheduled for diagnostic same-day bidirectional endoscopy between 16 February 2016 and 30 April 2016 were randomly assigned to the EGDcolonoscopy (n = 106) and colonoscopy-EGD (n = 103) sequence groups. Primary endpoint was total dose of propofol required for the procedure. Secondary endpoints included duration of endoscopy, patient satisfaction, adverse effects, endoscopy findings, and cardiopulmonary responses of the patients.Results: Patients in the two groups were similar in terms of demographic and clinical data (P > 0.05). EGD-colonoscopy sequence group had lesser requirement of propofol for sedation (P < 0.05), faster recovery (P < 0.001), and lesser influence on mean arterial pressure (MAP) during the endoscopy (P < 0.05). Duration of EGD and colonoscopy, patient satisfaction, adverse effects, and pathological findings did not differ between the two groups. Conclusions:The EGD-colonoscopy sequence may be considered the preferred sequence for same-day bidirectional endoscopy as a result of less cardiovascular stress, lessened need for sedation with propofol, and faster recovery.

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Section: Discussionsupporting

confidence: 90%

“…A study by Carter et al . in 2014 showed no significant difference in the discomfort and satisfaction of patients during BDE, regardless of the procedural sequence …”

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Comparison of procedural sequences in same‐day painless bidirectional endoscopy: Single‐center, prospective, randomized study

Cao

Yang

et al. 2017

Digestive Endoscopy

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show abstract

“…Three other studies, using moderate or deep sedation for BDE, showed that EGD followed by colonoscopy was superior in terms of better EGD tolerability and lower sedative dosages . However, a recent study with moderate sedation found that there was no difference in patient discomfort and satisfaction regarding the procedure sequence . Because carbon dioxide (CO 2 ) is absorbed across the intestines more rapidly than air, CO 2 insufflation has commonly been used in colonoscopies to decrease abdominal discomfort during and e after the procedure .…”

Section: Introductionmentioning

confidence: 99%

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

Chen

Cheng

Liu

et al. 2018

J of Gastro and Hepatol

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Sequence of same‐day upper and lower gastrointestinal endoscopy does not affect total procedure' time or medication use: A randomized trial

et al. 2019

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Background and AimSame‐day double upper and lower gastrointestinal endoscopy is frequently performed due to overlapping indications. However, it is unclear whether an upper–lower (U‐L) or lower–upper (L‐U) sequence is optimal. We analyzed the effect of sequence on total procedure time and sedation use.MethodsA total of 100 patients scheduled for same‐day double endoscopy were randomized to the U‐L or L‐U sequence arm. Primary outcomes, mean total procedure time, and sedative dosages were compared using a t‐test. We also explored associations of the primary outcomes with patient‐related and procedure‐related factors.ResultsComparing U‐L and L‐U sequences, mean total procedure time was 41.9 (16.2) versus 43.0 (14.5) min (P = 0.73), diphenhydramine dose 5.5 (15.4) versus 4.5 (14.0) mg (P = 0.74), fentanyl dose 71.5 (119.3) versus 77.6 (164.02) μg (P = 0.83), midazolam dose 1.6 (2.5) versus 1.4 (2.7) mg (P = 0.69), and propofol dose 437.4 (351.4) versus 444.5 (256.0) mg (P = 0.91), respectively. Total procedure and upper endoscopy times were significantly longer with trainee presence (P = 0.0002) and shorter with conscious sedation (P = 0.003). Upper endoscopy time was longer with higher body mass index (P = 0.001), and lower endoscopy time was longer in patients with cirrhosis or chronic kidney disease (P = 0.002 and 0.009, respectively). Time between procedures was significantly longer in the L‐U sequence (7.4 [2.9] vs 5.3 [1.1] min, [P < 0.001]). The study had 80% power to detect an 8 min difference in total procedure time.ConclusionsThe sequence of same‐day double gastrointestinal endoscopy does not affect total procedure time or medication use. Longer total procedure and upper endoscopy times were associated with trainee presence and use of conscious sedation.

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Comparison of Procedural Sequence in Same-day Consecutive Bidirectional Endoscopy Using Moderate Sedation

Abstract: There were no significant differences in the patient's discomfort and satisfaction, regardless of the procedural sequence.

Cited by 11 publications

References 3 publications

Comparison of procedural sequences in same‐day painless bidirectional endoscopy: Single‐center, prospective, randomized study

Comparison of procedural sequences in same‐day painless bidirectional endoscopy: Single‐center, prospective, randomized study

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

Sequence of same‐day upper and lower gastrointestinal endoscopy does not affect total procedure' time or medication use: A randomized trial

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