What factors are associated with the difficult-to-sedate endoscopy patient?.
Citation: Digestive Diseases & Sciences. 57(10):2527-34, 2012 Oct.PMID: 22565338Institution: MedStar Washington Hospital CenterDepartment: Medicine/Gastroenterology | Surgery/Colorectal SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Conscious Sedation/px [Psychology] | *Hypnotics and Sedatives | Adult | Alcoholism | Anxiety | Cohort Studies | Endoscopy | Female | Humans | Male | Middle Aged | Patient Satisfaction/sn [Statistics & Numerical Data] | Questionnaires | Sex Offenses | ViolenceYear: 2012Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1999 - 2006ISSN:- 0163-2116
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 22565338 | Available | 22565338 |
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: Difficult sedation during endoscopy results in inadequate examinations and aborted procedures. We hypothesized that gender, alcohol abuse, physical/sexual abuse, and anxiety are predictors of difficult-to-sedate endoscopy patients.
CONCLUSION: Pre-procedural state or trait anxiety is associated with difficult sedation during endoscopy. In this study neither alcohol abuse nor chronic opiate/BDZ use was associated with difficult sedation.
METHODS: This is a prospective cohort study. At the time of enrollment, subjects completed the following three validated questionnaires: state-trait anxiety inventory, self-report version of alcohol use disorder inventory, and Drossman questionnaire for physical/sexual abuse. Conscious sedation was administered for the endoscopic procedures at the discretion of the endoscopist and was graded in accordance with the Richmond agitation sedation scale (RASS). Subjects' perceptions of sedation were documented on a four-point Likert scale 24 h after their procedure.
RESULTS: One-hundred and forty-three (79 %) of the 180 subjects enrolled completed the study. On the basis of the RASS score, 56 (39 %) subjects were found to be difficult to sedate of which only five were dissatisfied with their sedation experience. State (n = 39; p = 0.003) and trait (n = 41; p = 0.008) anxiety and chronic psychotropic use (p = 0.040) were associated with difficult sedation. No association was found between difficult sedation and gender (p = 0.77), alcohol abuse (p = 0.11), sexual abuse (p = 0.15), physical abuse (p = 0.72), chronic opioid use (p = 0.16), or benzodiazepines (BDZ) use (p = 0.10).
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