Quality Criteria In Upper Gastrointestinal Endoscopy - Can Deep Sedation Influence It?

Aims In 2016, quality criteria for upper gastrointestinal endoscopy (UGE) were published by ESGE/UEG, but the problem of sedation was not addressed. However, it is known that the patient’s tolerance level is variable, assuming that some criteria may not be reached in non-sedated patients. The present research aims to determine whether the use of deep sedation influences the fulfillment of the quality criteria proposed by ESGE.

Methods: Patients and methods A preliminary prospective analysis of compliance with the ESGE quality criteria was carried out on 118 patients previously scheduled to perform diagnostic EDA, who were allocated to 2 groups, according to the request made by the attending physician: Group A - without sedation (n = 63; female-57.1 %; mean age-59.7 ± 17.6 years); Group B - with deep sedation under propofol (n = 55; female-67.3 %; mean age-62.8 ± 15.1 years).

Results Comparing the groups without and with sedation, there were statistically significance differences in the following parameters: the average duration of the EDA (6.7 ± 3.8 vs. 8.3 ± 2.6 minutes); capturing images of the main anatomical sites/changes found (79 % vs. 98.2 %); gastric biopsies, when indicated (61.3 % vs. 89.1 %).

EDA was considered to be complete in 74.6 % vs. 98.2 % (p <0.001) in group A and B, respectively, with intolerance being the main cause of interruption of the procedure.

The median level of patient satisfaction, determined based on a numerical scale (0 not satisfied - 10 very satisfied), was 6 in group A and 9 in group B (p <0.001).

Conclusions The preliminary results of this study seem to demonstrate the use of deep sedation is essential to perform a quality EDA in the way it is defined by ESGE/UEG. In addition, it appears that 25 % of procedures without sedation are incomplete, which can lead to false negatives and/or repetition of EDA.

Citation Correia C, Almeida N, Sant’Anna M et al. eP120 QUALITY CRITERIA IN UPPER GASTROINTESTINAL ENDOSCOPY - CAN DEEP SEDATION INFLUENCE IT?. Endoscopy 2021; 53: S135.

Publication History

Article published online:
19 March 2021