scholarly journals Safety Profile and Patient Satisfaction of the Routine use of Propofol in Gastrointestinal Endoscopy

2015 ◽  
Vol 12 (2) ◽  
pp. 101-105
Author(s):  
RB Gurung ◽  
B Purbe ◽  
B Malla ◽  
A Dhungel ◽  
S Yogol ◽  
...  

Background Routine use of sedation in upper gastrointestinal endoscopy is uncommon in Nepal. There is no study on use of propofol sedation in routine endoscopy examination in Nepal. This study was conducted in order to assess the patient satisfaction and safety profile in patient undergoing routine upper GI endoscopic examination on outpatients.Objective To study safety profile and patient satisfaction of use of propofol in patients undergoing upper GI endoscopy.Method A prospective, observational study was conducted in the endoscopy unit of Dhulikhel hospital, Kathmandu University Hospital from July 2011 to 2012 July. Patients who were referred to upper GI endoscopy were offered to sedation under propofol. Informed consent was taken after explaining side effects, advantages and risk-benefit to the clients. The propofol was administered by the endoscopy nurse under guidance and supervision of the endoscopy performing physician.Data were collected and analyzed using SPSS version 16.0 with 0.05 level of significance.Result Total of 203 patients included in the study. Among 203 patients, 21. 2% were males and 78.8% were females; 83.7% were of less than of 60 years age and 16.3% above 60 years of age. The mean total dose of propofol required was 136.08 ± 48.82 mg. Total of 29.1 % of cases required O2 administration during the procedure time due to transient drop in O2 saturation. Total of 4.4% of cases required fluid administration due to transient fall in blood pressure. Total of 68.0% of cases were completely sedated; 28.6% had minor restless and 3.4% showed agitation during induction period of propofol sedation. Total of 99.5% of patients reported pleasant experience while 0.5% reported unpleasant. Among 203 respondents, 98.5% responded they would prefer to do the procedure under propofol sedation in the future; 1.5% responded they did not want sedations in the future.Conclusion Upper GI endoscopy can safely be performed under propofol sedation administered by registered trained nurse under the supervision of endoscopist.Kathmandu University Medical Journal Vol.12(2) 2014: 101-105

2013 ◽  
Vol 3 (2) ◽  
pp. 35-38
Author(s):  
MC Anup Kumar ◽  
Lavanya Karanam

ABSTRACT Objective The need for upper gastrointestinal (GI) endoscopy in the evaluation of hoarseness. Study design Prospective study, conducted during the period from June 2012 to February 2013. Setting Tertiary referral center. Results A total of 125 patients were selected for the study and they were evaluated with appropriate history and clinical examination. Out of 125 patients, 41 (32.8%) patients showed laryngeal findings leading to hoarseness, 13 (10.4%) patients showed features of suspected malignancy in other adjacent regions which was confirmed later, two (1.6%) patients showed phonetic gap and 69 (55.2%) patients showed normal laryngeal inlet on indirect laryngoscopy examination. Of the 69 normal patients which were treated conservatively and since they did not show any response they were subjected to upper GI endoscopy. Out of 69 patients, 41 (60%) patients showed features of gastritis, 28 (40%) patients showed features of duodenitis. Conclusion It is estimated that more than 50% of patients presenting to the ENT OPD for hoarseness are because of GI problems. We strongly advise upper GI endoscopy for the symptomatic otorhinolaryngological patients with a normal laryngeal finding on indirect laryngoscopy for treating the condition accurately or near accurately. Adding to this upper GI endoscopy has the additional advantages of documentation and medicolegal aspect in the present day scenario. How to cite this article Santosh UP, Kumar MCA, Karanam L. Upper Gastrointestinal Endoscopy in ENT Practice: How Worth is It? Int J Phonosurg Laryngol 2013;3(2):35-38.


2019 ◽  
Vol 6 (10) ◽  
pp. 3595
Author(s):  
Shashidhara Puttaraju ◽  
Sudarshana Sreramaseshadri R. M.

Background: Upper gastrointestinal (GI) symptoms are the commonest complaints among the general population and the diseases associated with them carries a significant risk of morbidity and mortality. Hence early diagnosis and appropriate management of the condition can prevent life threatening complications. Upper GI endoscopy is an effective diagnostic as well as therapeutic tool for the patients presenting with upper GI symptoms. The objective of the study is to show the effectiveness of upper gastrointestinal endoscopy as an initial diagnostic, screening and therapeutic tool in patients with upper GI symptoms.Methods: Present study comprises of 100 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out-patients and referred patients) during the period of October 2018 to June 2019, who underwent upper GI endoscopy.Results: Out of 100 patients, 60 were males and 40 were females. In the study majority of the patients were found to have gastritis, esophagitis and acid peptic disease. Other patients had malignant changes, reflux disease, hiatus hernia, perforation, foreign body, obstruction and esophageal varices.Conclusions: Upper GI endoscopy is a simple, safe, more reliable and valuable tool with easy learning curve. It will remain as the initial investigation of choice for the patients with upper GI symptoms. It plays a significant role as a screening, diagnostic as well as therapeutic tool.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P < 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P < 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.


Author(s):  
Amir Shafa ◽  
Anahita Hirmanpour ◽  
Behzad Nazemroaya ◽  
Fateme Jafari ◽  
Arash Pourreza

Background: Endoscopy is a diagnostic and therapeutic method with a high risk of nausea and vomiting. Considering the lack of adequate studies on the prevention of postoperative nausea and vomiting after endoscopy in children, this study was conducted to compare the effects of ondansetron, dexamethasone and a combination of these drugs on the reduction of nausea and vomiting in children aged 1 to 12 years undergoing upper gastrointestinal endoscopy. Methods: In this double-blind, randomized clinical trial, 146 children aged 1 to 12 years, undergoing upper gastrointestinal endoscopy were randomly allocated to four groups of 36. Before endoscopy, the groups received 0.1 mg / kg of ondansetron, 0.2 mg / kg dexamethasone, a combination of the two drugs and placebo, respectively. Results: According to the results of our study, children who underwent upper GI endoscopy, administration of ondansetron plus dexamethasone was associated with a significantly lower frequency of nausea in all assessment time points. However, the difference between the groups was significant only on admission to recovery and the 15 minutes after admission to recovery (P<0.001). Conclusion: The results of our study indicated that in children undergoing endoscopy, the use of ondansetron plus dexamethasone is associated with reduction in the incidence of nausea and vomiting, and the use of the combination does not cause significant side effects compared to ondansetron, dexamethasone or placebo, separately.


2014 ◽  
Vol 21 (03) ◽  
pp. 460-464
Author(s):  
Muhammad Zakria ◽  
Awais Shuja

Objective: To document various endoscopic findings in patients undergoingupper GI endoscopy in our endoscopy unit. Design: Observational. Patients and methods: Thedata of 100 patients who underwent upper GI endoscopy in Endoscopy Unit of IndependentMedical College/ Independent University Hospital from April 2010 to December 2012 wasanalyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted.Results: Among 100 patients, 35% were referred due to persistent vomiting, 28% due toepigastric pain / discomfort, 18 % due to dyspepsia and 7% due to retrosternal burning and uppergastrointestinal bleeding. Common endoscopic diagnoses were gastritis (28%), duodenitis(14%), gastroesophageal reflux disease / esophagitis (6%), esophageal varices (5%) andesophageal growth (4%). Conclusions: The most common presenting complaint was persistentvomiting followed by epigastric pain / discomfort and the most common endoscopic finding wasgastritis.


2019 ◽  
Vol 19 (3) ◽  
pp. 279-283
Author(s):  
Taher El-Demerdash ◽  
Mohamed Yousef ◽  
Sherief Abd-Elsalam ◽  
Amal Helmy ◽  
Abdelrahman Kobtan ◽  
...  

Background and Aims: Hepatitis viruses are not transmitted via gastrointestinal endoscopy except if there are any mistakes in sterilization and disinfection of the endoscope that disrupt the infection control measures. So we aimed to measure the risk of transmitting HCV by GI endoscopy at department of Tropical Medicine and infectious Diseases, in a major University hospital in Egypt. Methods: Our study was conducted on four hundred patients with exclusion of those with HCV, HBV, and/or HIV positive antibodies. An ethical committee approval and a given consent were taken prior to enrollment on the study. Our patients are grouped into the following; 100 patients undergoing upper GI endoscopy without biopsy as group I; 100 patients undergoing upper GI endoscopy with biopsy as group II; 100 patients undergoing lower GI endoscopy without biopsy as group III and 100 patients undergoing lower GI endoscopy with biopsy as group IV. HCV antibodies were done 3 months after endoscopy with exclusion of other risks of HCV infection by a detailed questionnaire. Results: Only one case was reported positive after 3 months of procedure; it was after colonoscopy with biopsy using reusable forceps. Conclusion: Strict infection control measures of the GI endoscopes despite being effective in preventing HCV transmission, the reuse of disinfected biopsy forceps may be associated with a risk of transmission. So, we recommend using disposable forceps for every patient to omit the risk of HCV transmission during endoscopy.


2011 ◽  
Vol 74 (6) ◽  
pp. 1207-1214 ◽  
Author(s):  
Ludwig T. Heuss ◽  
Andreas Hanhart ◽  
Salome Dell-Kuster ◽  
Karolina Zdrnja ◽  
Michael Ortmann ◽  
...  

2019 ◽  
Vol 11 (2) ◽  
pp. 25-29
Author(s):  
Azizun Nessa ◽  
Muhammad Rabiul Hossain ◽  
Md Habibur Rahman ◽  
SM Mizanur Rahman ◽  
Abdullah Al Mamun ◽  
...  

Introduction: Dyspepsia affects up to 40% of the general population and significantly reduces the quality of life. Dyspeptic symptoms may be associated with endoscopically negative conditions, such as functional dyspepsia, or with organic lesions like peptic ulcer and oesophagitis which are easily detected by endoscopy. On the other hand, such lesions may also be asymptomatic and there is not always a clear cause and effect relationship between endoscopic findings and symptoms. Objective: To determine the prevalence of significant endoscopic lesion and or ultrasonographic findings and their association with dyspeptic symptoms in Bangladeshi rural population. Materials and Methods: This prospective cross sectional study was carried out in Nov 2015 to Dec 2015 in a field mobile hospital of Bangladesh Army, established in Daudkandi, Comilla where total 1094 uninvestigated dyspeptic patients were invited to participate in this cross sectional study and 105 typical dyspeptic patients were finally recruited as per Rome III criteria. Participants underwent clinical assessment through a preformed structured questionnaire and non video upper gastrointestinal endoscopy (UGIE) and ultrasonogram (USG) of hepatobiliary system (HBS). Results: The mean age of 105 participants (male-29; female-76) studied was 36.51±7.26 years with female preponderance (72.38%). Predominant symptoms were epigastric pain (69.52%), flatulence (34.28%), heart burn (28.57%) and diffuse abdominal pain (22.85%). Regarding treatment 48(45.71%) patients took proton pump inhibitors (PPI), 24 patients (22.85%) took H2 receptor blocker and 13 patients (12.38%) were on antacids irregularly. Seventeen patients (16.15%) had no history of medications for dyspepsia. Most of the patients (76.19%) had symptoms of less than 5 years. Organic dyspepsia was found in 68(64.76%) and functional dyspepsia in 37(35.23%) participants. Percentage of functional dyspepsia in male was 24.13% and in female it was 39.47% and the difference was statistically significant (p<0.05). In the organic dyspepsia group, upper GI endoscopy revealed 07(6.66%) duodenal ulcer, 02(1.9%) gastric ulcer, 04(3.8%) prepyloric ulcer and other inflammatory lesions like prepyloric gastritis in 46(43.80%) patients, antral gastritis in 06(5.7%) patients, duodenitis in 08(7.61%) patients and erosive oesophagitis in 03 patients(2.86%). Further USG revealed cholelithiasis in 02(1.90%) and gall bladder (GB) polyp in 01(0.95%) participants which could be the reason for their dyspeptic symptoms. Thirty Seven (35.23%) participants had normal UGIE (and also normal USG of HBS) but they had significant dyspeptic symptoms. Conclusion: Most of the patients (64.76%) in this study had significant upper GI endoscopic findings and labeled as organic dyspepsia and combined use of upper GI endoscopy and USG of HBS provided better yield for aetiological diagnosis of dyspepsia if there is any. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 25-29


2019 ◽  
Vol 6 (6) ◽  
pp. 1938 ◽  
Author(s):  
Harsha Narayan ◽  
Nagaraj Ravishankar ◽  
Shivakumar Shivabasappa ◽  
Nalini Kotekar

Background: Asymptomatic gallbladder stones are often diagnosed as an incidental finding. Gallstone disease is asymptomatic in most patients diagnosed to have gall stone and cholecystectomy is considered to be the treatment of choice. However, less focus has been given to patient selection and to the symptoms of this disease in order to understand prevailing symptoms after surgery. Studies suggest that approximately 25% of patients undergoing cholecystectomy will not experience relief of symptoms, and that dyspeptic symptoms are least likely to be cured by cholecystectomy. Post-cholecystectomy syndrome (PCS) consists of a group of symptoms that persist after cholecystectomy. It is defined as early if occurring in the post-operative period and late if it manifests after months or years. The objectives of the study were to emphasize the importance of endoscopic evaluation as a routine pre-operative investigative tool in patients with dyspepsia and gall stones and evaluate the prevalence of dyspeptic symptoms in patients with gall stone disease.Methods: 92 patients with USG proven gall stones presenting with dyspepsia attending OPD or admitted in surgery department (JSS Hospital) were studied. Upper GI endoscopy was performed to detect for significant lesions.Results: Most common endoscopic finding was gastritis. Malignancy was found in 3 (3.3%) patients. The management plan was changed for 9 (13.6%) patients.Conclusions: Significant endoscopic findings were observed in 72.8% of patients. Routine pre-operative upper GI endoscopy is recommended in all patients with gall-stone disease who present with dyspepsia to avoid unnecessary cholecystectomy.


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