BMJ 1995;311:453 (12 August)

Letters

Italian data support upper gastrointestinal endoscopy without sedation

EDITOR,--J E Charlton claims that closer monitoring, as well as routine oxygen, during upper gastrointestinal endoscopy would reduce morbidity related to this procedure.1 Charlton wonders whether it is safe to dismiss cardiographic abnormalities and low oxygen desaturation, since in a recent survey nearly all the complications were respiratory or cardiovascular.2 In the same survey 85% of upper gastrointestinal endoscopies were performed under sedation, a figure similar to that detected in a survey in 1990, in which sedation was shown to be the main cause of adverse outcomes.3

We believe that performing upper gastrointestinal endoscopy without sedation would greatly improve its safety and cost effectiveness without any appreciable reduction of efficiency. In our institution, since May 1993, we have performed upper gastrointestinal endoscopies routinely without sedation, with local anaesthesia by lignocaine spray of the oropharynx. We have reviewed the incidental endoscopies performed in the past three months (n=353) to assess the . . . [Full text of this article]


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Relevant Article

Monitoring and supplemental oxygen during endoscopy
J E Charlton
BMJ 1995 310: 886-887. [Extract] [Full Text]

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