Unsedated Esophagogastroduodenoscopy in Cirrhotic Patients: An Impact of Topical Pharyngeal Anesthesia

Abstract

Topical pharyngeal anesthesia is generally used as pretreatment for unsedated esophagogastroduodenoscopy (UEGD). The effectiveness of topical pharyngeal anesthesia for UEGD in cirrhotic patients has been limited reports in the medical literature. The study is aimed to study the impact of topical pharyngeal anesthesia for UEGD procedure in cirrhotic patients in the World Gastroenterology Organization Endoscopy Training Center in Thailand. Retrospectively analyzed the patients on whom UEGD procedures had been performed during the period of December, 2007 to May, 2009 in Siriraj Hospital. The patients’ characteristics, duration of procedure, preanesthetic problems and anesthesia-related adverse events were assessed. The primary outcome variable of the study was the successful completion of the procedure. The secondary outcome variables were anesthesia-related adverse events and the alteration of hemodynamic parameters. During the study period, there were 346 cirrhotic patients who underwent UEGD procedure. All UEGD procedures were succeeded except four cases. The mean age of the patients was 55.9±11.9 years, and most were American Society of Anesthesiologists (ASA) class II (53.2%). The mean duration of procedure was 13.5±7.4 minutes. Topical pharyngeal anesthesia for UEGD procedure in the cirrhotic patients is relatively safe and effective. Anesthesiarelated adverse events in the cirrhotic patients were relatively high. However, these adverse events were mild, transient, without specific interventions, with no adverse sequelae.