Prospective of Anesthesia for Gastrointestinal Endoscopy from 2006 - 2007 at Surin Provincial Hospital

Abstract

Background : Gastrointestinal endoscopy is a procedure for diagnosis and treatment of Gl abnormalities. It is one of the most common interventional medical procedures performed throughout the world. However, a “successful endoscopy" is related to the choices and techniques of anesthesia.

Objective : To study anesthetic data such as choices and techniques, drug usage and complications of anesthesia for Gl endoscopy from 2006-2007.

Setting : Surin Provincial Hospital

Research design : A prospective study

Patients : The patients undergoing Gl endoscopy during the period of October, 2006 to September, 2007 at the Divisions of Medicine and Surgery of Surin Provincial Hospital.

Method : We analyzed the patients’ characteristics, preanesthetic problems, anesthetic techniques, agents, time, and complications, as well as endoscopic procedures and summarized by using descriptive statistics.

Results : This study reviewed 1,337 cases and 1,410 endoscopic procedures Conclusion i.e. esophagogastroduodenoscopy (70.78 %), gastroscopy (20.99 %), colonoscopy (5.46 %), sigmoidoscopy (2.70 %), and proctoscopy (0.07 %). The majority of them were in the age group of 51-60 years old (22.84 %) and classified in ASA class II (80.64 %). The diagnoses were gastritis (37.24 %), esophageal varices (18.79 %), peptic ulcer (17.20 %), upper gastrointestinal hemorrhage (6.17%), dyspepsia (2.70%),and others. Most common preanesthetic problems were hematologic diseases (18.81 %), alteration of consciousness (13.86 %), hypotension (8.91 %) and cardiovascular diseases (7.92 %). Topical pharyngeal anesthesia (92.52 %) and intravenous sedation (3.78 %) were the main anesthetic techniques. The mainly used anesthetic agents were lidocaine, fentanyl, midazolam and propofol. The anesthetic duration ranged from 5 to 100 minutes (10.62±6.76). The overall complication rate was 12.87%. Hypotension (4.95 %) was the most frequently found anesthetic complication.

Conclusion : Almost all cases of the Gl endoscopy can be performed under Keywords topical anesthesia. Sedation-related risk factors, the depth of sedation, and the urgency of the endoscopic procedure. All these played important roles in determining whether or not the assistance of an anesthesiologist is needed.