Research Article
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How sedation used prior to gastrointestinal endoscopies affects patients' anxiety level for future procedures

Year 2023, , 63 - 68, 10.02.2023
https://doi.org/10.47582/jompac.1233543

Abstract

Aim: The application of sedoanalgesia during gastrointestinal endoscopic procedures increases the success of the procedure as well as patient comfort and safety. The aims of this study are to investigate the anxiety levels of patients and potential early complications who practised sedoanalgesia in gastrointestinal endoscopic procedures before and two days after.
Material and Method: The study was designed as a prospective, randomized, single-centre clinical trial. Patients over the age of 18 and had American Society of Anaesthesiology (ASA) physical status score 1-3 who were practised elective gastrointestinal endoscopy, between April 2022 and September 2022 were included to the study. The patients who refused to participate, were above ASA 3, and were illiterate, had an Ejection Fraction <30%, and had a diagnosis and treatment of psychiatric disease were excluded from the study. Informed consent obtained from all patients. Anxiety levels of the patients were evaluated with Beck Anxiety Inventory (BAI). Hemodynamic changes, blood test results were recorded and compared before and after the procedure.
Results: One hundred four patients included to the study with the age of 23 to 79. Preoperative and postoperative BAI scores were found statistically significant (p<0.05). The patients’ satisfactions have seen very high after procedure. The complications have seen on 7 (%6.7) patients. All of the complications were due to nature of the procedure as epistaxis/mucosal trauma (n=3), equipment damage(n=4). There have been no serious or life-threatening complications during procedures.
Conclusion: Reducing anxiety by anaesthesia, patients will be more efficiently persuaded to execute endoscopy and by thus early diagnosis can be achieved. Patients who have undergone an endoscopy procedure while sedated have significantly fewer concerns about the future. This may increase the procedure's chances of success every time.

Supporting Institution

Yok

Project Number

Yok

Thanks

We would like to thank all the editors and referees in the Journal of Medicine and Palliative Care for their intense efforts for creating a platform where we can present our work for their valuable evaluation.

References

  • Mulugeta H, Ayana M, Sintayehu M, Dessie G, Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol 2018; 30: 155.
  • Rex DK, Khalfan HK. Sedation and the technical performance of colonoscopy. Gastrointest Endosc Clin N Am 2005; 15: 661-72.
  • Obara K, Haruma K, Irisawa A, et al. Guidelines for sedation in gastroenterological endoscopy. Dig Endosc 2015; 27: 435-49.
  • McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc 2008; 67: 910–23.
  • Baudet JS, Aguirre-Jaime A. The sedation increases the acceptance of repeat colonoscopies. Eur J Gastroenterol Hepatol 2012; 24: 775–80.
  • Kinugasa H, Higashi R, Miyahara K, et al. Dexmedetomidine for conscious sedation with colorectal endoscopic submucosal dissection: A prospective double-blind randomized controlled study. Clin Transl Gastroenterol 2018; 9: e167.
  • Wernli KJ, Brenner AT, Rutter CM, et al. Risks associated with anesthesia services during colonoscopy. Gastroenterology 2016; 150: 888–94.
  • Bielawska B, Hookey LC, Sutradhar R, et al. Anesthesia assistance in outpatient colonoscopy and risk of aspiration pneumonia, bowel perforation, and splenic injury. Gastroenterology 2018; 154: 77–85.
  • American Society of Anaesthesiologists. Statement on granting privileges to nonanesthesiologist practitioners for personally administering deep sedation or supervising deep sedation by individuals who are not anesthesia professionals. Approved by the ASA House of Delegates on October 18, 2006. Available at: http: //www.asahq.org/publicationsAndServices/standards/ 39.pdf.
  • Peker K. Preoperatif anksiyetenin değerlendirilmesinde Beck ve Durumluk-Sürekli Anksiyete ölçeklerinin karşılaştırılması. JARSS 2020; 28: 109-15.
  • Spielberger CD. Manual for the state-trait anxietry, inventory. Consulting Psychologist, 1970.
  • Bardhoshi G, Duncan K, Erford BT. Psychometric meta-analysis of the English version of the beck anxiety inventory. J Couns Dev 2016; 94: 356–73.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;  56: 893–7.
  • Beck AT, Steer RA, Beck JS. Types of self-reported anxiety in outpatients with DSM-III-R anxiety disorders1. Anxiety Stress Coping 1993; 6: 43–55.
  • Beck AT, Steer RA. BAI, Beck Anxiety Inventory: Manual; Psychological Corporation: San Antonio, TX, USA, 1993.
  • Toledano-Toledano F, Moral de la Rubia J. Factors associated with anxiety in family caregivers of children with chronic diseases. Bio Psycho Soc Med 2018;  12: 20. 
  • Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the beck anxiety inventory and its factors as a screener for anxiety disorders. J. Anxiety Disord 2006;  20: 444–58.
  • Muntingh AD, van der Feltz-Cornelis CM, van Marwijk HW, Spinhoven P, Penninx BW, van Balkom AJ. Is the Beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in the Netherlands Study of Depression and Anxiety (NESDA). BMC Fam Pract 2011; 12: 66.
  • Veitch AM, Uedo N, Yao K, East JE. Optimizing early upper gastrointestinal cancer detection at endoscopy. Nat Rev Gastroenterol Hepatol 2015; 12: 660–7.
  • 20.Saftoiu A, Hassan C, Areia M, et al. Role of gastrointestinal endoscopy in the screening of digestive tract cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 293–304.
  • Inadomi JM, Gunnarsson CL, Rizzo JA, Fang H. Projected increased growth rate of anesthesia professional-delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015. Gastrointest Endosc 2010; 72: 580-6.
  • Uysal H, Daskaya H. Analysis of anesthesia administration in the endoscopy unit in terms of patient profile and complications: Retrospective study. Medeniyet Med J 2019; 34: 278-83.
  • Sargin M, Uluer MS, Aydogan E, et al. Anxiety levels in patients undergoing sedation for elective upper gastrointestinal endoscopy and colonoscopy. Med Arch 2016; 70: 112–5.
  • Jones MP, Ebert CC, Sloan T, et al. Patient anxiety and elective gastrointestinal endoscopy. J Clin Gastroenterol 2004; 38: 35–40.
  • Ersöz F, Toros AB, Aydogan G, Bektas H, Ozcan O, Arikan S. Assessment of anxiety levels in patients during elective upper gastrointestinal endoscopy and colonoscopy. Turk J Gastroenterol 2010; 21: 29–33.
  • Van Kerkhoven LA, Van Rossum LG, Van Oijen MG, et al. Anxiety, depression and psychotropic medication use in patients with persistent upper and lower gastrointestinal symptoms. Aliment Pharmacol Ther 2005; 15: 1001-6.
  • Chung YW, Han DS, Yoo KS, Park CK. Patient factors predictive of pain and difficulty during sedation-free colonoscopy: a prospective study in Korea. Dig Liver Dis 2007; 39: 872-6.
  • Caumo W, Schmidt AP, Schneider CN, et al. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 2001; 45: 298-307.
  • Nigussie S, Belachew T, Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia. BMC Surg 2014; 14: 67.
  • Wardle J, Williamson S, Sutton S, et al. Psychological impact of colorectal cancer screening. Health Psychol 2003; 22: 54-9.
  • Previti G, Bianchini O, Dipasquale S, et al. Anxiety in patients undergoing endoscopic procedures: identifying people at risk. Ann Depress Anxiety 2016; 3: 1072.
  • Jafar MF, Khan FA. Frequency of preoperative anxiety in Pakistani surgical patients. J Pak Med Assoc 2009; 59: 359-63.
  • Prathapan S, Wanigabandu LU, Lamahewage N, et al. Anxiety of patients undergoing general anaesthesia and their myths and beliefs. Sri Lankan J Anaesthesiol 2013; 22: 11–4.
  • Erdal H, Gündoğmuş İ, Sinan Aydın M, et al. Is the choice of anesthesia during gastrointestinal endoscopic procedures a result of anxiety? Arab J Gastroenterol 2021; 22: 56-60.

Gastrointestinal endoskopiler öncesinde uygulanan sedasyon hastaların gelecekteki işlemler için kaygı düzeyini nasıl etkiler?

Year 2023, , 63 - 68, 10.02.2023
https://doi.org/10.47582/jompac.1233543

Abstract

Amaç: Gastrointestinal endoskopik işlemler sırasında sedoanaljezi uygulaması, işlem başarısının yanı sıra hasta konforu ve güvenliğini de artırmaktadır. Bu çalışmanın amacı, gastrointestinal endoskopik işlemlerde sedoanaljezi uygulanan hastaların anksiyete düzeylerini ve olası erken komplikasyonları gastrointestinal endoskopik işlemlerden önce ve iki gün sonra araştırmaktır.
Gereç ve Yöntem: Çalışma prospektif, randomize, tek merkezli bir klinik araştırma olarak tasarlandı. Nisan 2022-Eylül 2022 tarihleri arasında elektif gastrointestinal endoskopi uygulanan 18 yaş üstü, American Society of Anesthesiology (ASA) fiziksel durum skoru 1-3 olan hastalar çalışmaya dahil edildi. Çalışmaya katılmayı reddeden, ASA 3 üzerinde olan, okuma yazma bilmeyen, Ejeksiyon Fraksiyonu <%30 olan, psikiyatrik hastalık tanı ve tedavisi olan hastalar çalışma dışı bırakıldı. Tüm hastalardan bilgilendirilmiş onam alındı. Hastaların anksiyete düzeyleri Beck anksiyete envanteri (BAÖ) ile değerlendirildi. İşlem öncesi ve sonrası hemodinamik değişiklikler, kan testi sonuçları kaydedildi ve karşılaştırıldı.
Sonuç: Anestezi ile anksiyetinin azaltılması hastalara daha etkin bir şekilde endoskopi yapılmasını ve erken tanı konulabilmesini sağlamaktadır. Sedasyon sırasında endoskopi prosedürü geçiren hastaların gelecekle ilgili önemli ölçüde daha az anksiyeteleri azalmaktadır. Bu sayede prosedürün her seferinde başarı şansı artabilir.

Project Number

Yok

References

  • Mulugeta H, Ayana M, Sintayehu M, Dessie G, Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol 2018; 30: 155.
  • Rex DK, Khalfan HK. Sedation and the technical performance of colonoscopy. Gastrointest Endosc Clin N Am 2005; 15: 661-72.
  • Obara K, Haruma K, Irisawa A, et al. Guidelines for sedation in gastroenterological endoscopy. Dig Endosc 2015; 27: 435-49.
  • McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc 2008; 67: 910–23.
  • Baudet JS, Aguirre-Jaime A. The sedation increases the acceptance of repeat colonoscopies. Eur J Gastroenterol Hepatol 2012; 24: 775–80.
  • Kinugasa H, Higashi R, Miyahara K, et al. Dexmedetomidine for conscious sedation with colorectal endoscopic submucosal dissection: A prospective double-blind randomized controlled study. Clin Transl Gastroenterol 2018; 9: e167.
  • Wernli KJ, Brenner AT, Rutter CM, et al. Risks associated with anesthesia services during colonoscopy. Gastroenterology 2016; 150: 888–94.
  • Bielawska B, Hookey LC, Sutradhar R, et al. Anesthesia assistance in outpatient colonoscopy and risk of aspiration pneumonia, bowel perforation, and splenic injury. Gastroenterology 2018; 154: 77–85.
  • American Society of Anaesthesiologists. Statement on granting privileges to nonanesthesiologist practitioners for personally administering deep sedation or supervising deep sedation by individuals who are not anesthesia professionals. Approved by the ASA House of Delegates on October 18, 2006. Available at: http: //www.asahq.org/publicationsAndServices/standards/ 39.pdf.
  • Peker K. Preoperatif anksiyetenin değerlendirilmesinde Beck ve Durumluk-Sürekli Anksiyete ölçeklerinin karşılaştırılması. JARSS 2020; 28: 109-15.
  • Spielberger CD. Manual for the state-trait anxietry, inventory. Consulting Psychologist, 1970.
  • Bardhoshi G, Duncan K, Erford BT. Psychometric meta-analysis of the English version of the beck anxiety inventory. J Couns Dev 2016; 94: 356–73.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;  56: 893–7.
  • Beck AT, Steer RA, Beck JS. Types of self-reported anxiety in outpatients with DSM-III-R anxiety disorders1. Anxiety Stress Coping 1993; 6: 43–55.
  • Beck AT, Steer RA. BAI, Beck Anxiety Inventory: Manual; Psychological Corporation: San Antonio, TX, USA, 1993.
  • Toledano-Toledano F, Moral de la Rubia J. Factors associated with anxiety in family caregivers of children with chronic diseases. Bio Psycho Soc Med 2018;  12: 20. 
  • Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the beck anxiety inventory and its factors as a screener for anxiety disorders. J. Anxiety Disord 2006;  20: 444–58.
  • Muntingh AD, van der Feltz-Cornelis CM, van Marwijk HW, Spinhoven P, Penninx BW, van Balkom AJ. Is the Beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in the Netherlands Study of Depression and Anxiety (NESDA). BMC Fam Pract 2011; 12: 66.
  • Veitch AM, Uedo N, Yao K, East JE. Optimizing early upper gastrointestinal cancer detection at endoscopy. Nat Rev Gastroenterol Hepatol 2015; 12: 660–7.
  • 20.Saftoiu A, Hassan C, Areia M, et al. Role of gastrointestinal endoscopy in the screening of digestive tract cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 293–304.
  • Inadomi JM, Gunnarsson CL, Rizzo JA, Fang H. Projected increased growth rate of anesthesia professional-delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015. Gastrointest Endosc 2010; 72: 580-6.
  • Uysal H, Daskaya H. Analysis of anesthesia administration in the endoscopy unit in terms of patient profile and complications: Retrospective study. Medeniyet Med J 2019; 34: 278-83.
  • Sargin M, Uluer MS, Aydogan E, et al. Anxiety levels in patients undergoing sedation for elective upper gastrointestinal endoscopy and colonoscopy. Med Arch 2016; 70: 112–5.
  • Jones MP, Ebert CC, Sloan T, et al. Patient anxiety and elective gastrointestinal endoscopy. J Clin Gastroenterol 2004; 38: 35–40.
  • Ersöz F, Toros AB, Aydogan G, Bektas H, Ozcan O, Arikan S. Assessment of anxiety levels in patients during elective upper gastrointestinal endoscopy and colonoscopy. Turk J Gastroenterol 2010; 21: 29–33.
  • Van Kerkhoven LA, Van Rossum LG, Van Oijen MG, et al. Anxiety, depression and psychotropic medication use in patients with persistent upper and lower gastrointestinal symptoms. Aliment Pharmacol Ther 2005; 15: 1001-6.
  • Chung YW, Han DS, Yoo KS, Park CK. Patient factors predictive of pain and difficulty during sedation-free colonoscopy: a prospective study in Korea. Dig Liver Dis 2007; 39: 872-6.
  • Caumo W, Schmidt AP, Schneider CN, et al. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 2001; 45: 298-307.
  • Nigussie S, Belachew T, Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia. BMC Surg 2014; 14: 67.
  • Wardle J, Williamson S, Sutton S, et al. Psychological impact of colorectal cancer screening. Health Psychol 2003; 22: 54-9.
  • Previti G, Bianchini O, Dipasquale S, et al. Anxiety in patients undergoing endoscopic procedures: identifying people at risk. Ann Depress Anxiety 2016; 3: 1072.
  • Jafar MF, Khan FA. Frequency of preoperative anxiety in Pakistani surgical patients. J Pak Med Assoc 2009; 59: 359-63.
  • Prathapan S, Wanigabandu LU, Lamahewage N, et al. Anxiety of patients undergoing general anaesthesia and their myths and beliefs. Sri Lankan J Anaesthesiol 2013; 22: 11–4.
  • Erdal H, Gündoğmuş İ, Sinan Aydın M, et al. Is the choice of anesthesia during gastrointestinal endoscopic procedures a result of anxiety? Arab J Gastroenterol 2021; 22: 56-60.
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Jülide Sayin Kart 0000-0002-7848-3685

Ummahan Dalkilinc Hokenek 0000-0003-0282-9034

Project Number Yok
Publication Date February 10, 2023
Published in Issue Year 2023

Cite

AMA Sayin Kart J, Dalkilinc Hokenek U. How sedation used prior to gastrointestinal endoscopies affects patients’ anxiety level for future procedures. J Med Palliat Care / JOMPAC / Jompac. February 2023;4(1):63-68. doi:10.47582/jompac.1233543

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