7214 Gastrointestinal endoscopy at a large urban medical center v - use of conscious sedation for esophagogastroduodenoscopy (egd).

Abstract

During the period of 1/97-4/99 767 EGD examinations were performed at Kings County Medical Center. All employed standard size video endoscopic equipment. 2 cases (0.2%) were done under general anesthesia. 227 (29.6%) of these examinations were performed without the use of any sedation. In 538 (70.1 %) conscious sedation was employed. Versed alone (mean dose=1.14mg) was used in 59.6 % of cases; 61.6% routine cases (mean=1.09 mg), and 55.3% emergency cases (mean=1.23mg). Versed and Demerol were given in 5.0 % of routine (mean=1.16 and 27.63mg, respectively) and 10.7 % of emergency cases (2.56 and 38.89 mg). Demerol alone was given in 0.7% of routine(mean 32.5 mg), and 1% of emergency cases (25 mg). Successful completion of examinations was achieved in 90.3% of those receiving no sedation and 87.9% of sedated patients. The mean age of unsedated patients was 57.1 years, while sedated patients were 53.5 years. 12.8% percent of unsedated patients were examined emergently. Choice of sedation could not be related to the indication for procedures. There were 2 complications (0.3%), both micro-perforations of the esophagus requiring no invasive treatment. Conclusions: 1. A major fraction of EGD were performed with no sedation. 2. In sedated patients, the dose of medications was minimal. 3. Completion rates were relatively low, but did not vary as a function of sedation at the doses given. 4. No patient experienced cardiopulmonary complications. 5. 90% of patients tolerated EGD using standard equipment in the absence of sedation. During the period of 1/97-4/99 767 EGD examinations were performed at Kings County Medical Center. All employed standard size video endoscopic equipment. 2 cases (0.2%) were done under general anesthesia. 227 (29.6%) of these examinations were performed without the use of any sedation. In 538 (70.1 %) conscious sedation was employed. Versed alone (mean dose=1.14mg) was used in 59.6 % of cases; 61.6% routine cases (mean=1.09 mg), and 55.3% emergency cases (mean=1.23mg). Versed and Demerol were given in 5.0 % of routine (mean=1.16 and 27.63mg, respectively) and 10.7 % of emergency cases (2.56 and 38.89 mg). Demerol alone was given in 0.7% of routine(mean 32.5 mg), and 1% of emergency cases (25 mg). Successful completion of examinations was achieved in 90.3% of those receiving no sedation and 87.9% of sedated patients. The mean age of unsedated patients was 57.1 years, while sedated patients were 53.5 years. 12.8% percent of unsedated patients were examined emergently. Choice of sedation could not be related to the indication for procedures. There were 2 complications (0.3%), both micro-perforations of the esophagus requiring no invasive treatment. Conclusions: 1. A major fraction of EGD were performed with no sedation. 2. In sedated patients, the dose of medications was minimal. 3. Completion rates were relatively low, but did not vary as a function of sedation at the doses given. 4. No patient experienced cardiopulmonary complications. 5. 90% of patients tolerated EGD using standard equipment in the absence of sedation.