Comparison Of Data Obtained from Sedated versus Unsedated Wireless Telemetry Capsule Placement: Does Sedation Affect the Results of Ambulatory 48-Hour pH Testing?

Abstract

The introduction of 48-hour wireless pH testing provides a novel technique of evaluating persons with suspected reflux disease. The wireless capsule can be placed in a sedated individual at the time of esophagogastroduodenoscopy (EGD) or in an unsedated individual at a time after the initial EGD, at the time of esophageal manometry or at the time of transnasal esophagoscopy. The effect that sedation has on the results of 48-hour wireless pH testing has not been evaluated. To evaluate the day to day variability and the effect of sedation on the results of 48-hour wireless pH testing. The charts of all patients at a tertiary swallowing center undergoing 48-hour wireless pH testing between June 1, 2003 and December 31, 2004 were retrospectively evaluated. Data concerning study indications, route of pH capsule placement, duration of pH recording, and test results were collected. Day to day variability was evaluated, and the results obtained from persons with sedated and unsedated pH capsule placement were compared. Two hundred and six studies were performed. The indications for the examination were gastroesophageal reflux disease (146/206), chronic cough (36/206), and laryngopharyngeal reflux (24/206). Sixty-two percent (128/206) of the studies were performed without sedation and 38% (78/206) with sedation. The overall reproducibility of the daily pH recordings (day 1 vs. day 2) was 77%. Although some trends were observed, there was no significant association between the use of sedation and any of the reflux parameters on pH testing (P > .05). The day to day reproducibility of 48-hour wireless pH testing was 77%. Intravenous sedation does not appear to have a significant effect on the results of 48-hour wireless pH testing.