Esophagogastroduodenal endoscopy (EGDE) is the most commonly performed endoscopic procedure in Canada and represents 51--65% of all gastrointestinal procedures performed in teaching hospitals. The routine use of conscious sedation during EGDE has facilitated its diffusion, ensured patient and physician satisfaction and has increased the potential risk of cardiorespiratory morbidity. It remains unclear if all adult ambulatory patients require routine conscious sedation prior to diagnostic EGDE, as the efficacy and safety of such a policy has not been rigorously studied in a North American population. / Patients were randomly assigned to sedation or placebo in a double-blind trial. / So far 360 patients of the anticipated patients have been enrolled, (182 randomized to sedation, 178 randomized to placebo). Groups were similar for all baseline characteristics. Eighty-one percent of patients randomized to placebo were able to complete EGDE without sedation. The major determinant of "successful endoscopy" was the use of sedation (OR = 7.52; 95% CI: 4.61--12.26). Preliminary subgroup analysis suggested that among patients greater than 55 yrs and with decreased pharyngeal sensitivity, there was a greater likelihood of successful unsedated endoscopy, when compared to other subsets (45% successful vs. 39% successful among the unstratified placebo population; 98% power). / The use of sedation does not improve technical adequacy. However, the use of sedation in the performance of EGDE is the strongest predictor of a successful endoscopy, patient self-reported satisfaction and willingness to repeat the procedure.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.78233 |
| Date | January 2002 |
| Creators | Abraham, Neena S. |
| Contributors | Collett, J. P. (advisor), Barkun, A. (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001976414, proquestno: AAIMQ88141, Theses scanned by UMI/ProQuest. |
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