What factors are associated with the difficult-to-sedate endoscopy patient?

Bikram S. Bal, Michael D. Crowell, Divyanshoo R. Kohli, Jiana Menendez, Farzin Rashti, Anjali S. Kumar, Kevin W. Olden

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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. 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). 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.

Original languageEnglish (US)
Pages (from-to)2527-2534
Number of pages8
JournalDigestive Diseases and Sciences
Volume57
Issue number10
DOIs
StatePublished - Oct 2012

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Endoscopy
Sex Offenses
Anxiety
Alcoholism
Benzodiazepines
Opiate Alkaloids
Conscious Sedation
Equipment and Supplies
Self Report
Opioid Analgesics
Cohort Studies
Alcohols
Prospective Studies
Physical Abuse
Surveys and Questionnaires

Keywords

  • Abuse
  • Anxiety
  • Difficult to sedate
  • Endoscopy

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Bal, B. S., Crowell, M. D., Kohli, D. R., Menendez, J., Rashti, F., Kumar, A. S., & Olden, K. W. (2012). What factors are associated with the difficult-to-sedate endoscopy patient? Digestive Diseases and Sciences, 57(10), 2527-2534. https://doi.org/10.1007/s10620-012-2188-2

What factors are associated with the difficult-to-sedate endoscopy patient? / Bal, Bikram S.; Crowell, Michael D.; Kohli, Divyanshoo R.; Menendez, Jiana; Rashti, Farzin; Kumar, Anjali S.; Olden, Kevin W.

In: Digestive Diseases and Sciences, Vol. 57, No. 10, 10.2012, p. 2527-2534.

Research output: Contribution to journalArticle

Bal, BS, Crowell, MD, Kohli, DR, Menendez, J, Rashti, F, Kumar, AS & Olden, KW 2012, 'What factors are associated with the difficult-to-sedate endoscopy patient?', Digestive Diseases and Sciences, vol. 57, no. 10, pp. 2527-2534. https://doi.org/10.1007/s10620-012-2188-2
Bal BS, Crowell MD, Kohli DR, Menendez J, Rashti F, Kumar AS et al. What factors are associated with the difficult-to-sedate endoscopy patient? Digestive Diseases and Sciences. 2012 Oct;57(10):2527-2534. https://doi.org/10.1007/s10620-012-2188-2
Bal, Bikram S. ; Crowell, Michael D. ; Kohli, Divyanshoo R. ; Menendez, Jiana ; Rashti, Farzin ; Kumar, Anjali S. ; Olden, Kevin W. / What factors are associated with the difficult-to-sedate endoscopy patient?. In: Digestive Diseases and Sciences. 2012 ; Vol. 57, No. 10. pp. 2527-2534.
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title = "What factors are associated with the difficult-to-sedate endoscopy patient?",
abstract = "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. 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). 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.",
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AU - Bal, Bikram S.

AU - Crowell, Michael D.

AU - Kohli, Divyanshoo R.

AU - Menendez, Jiana

AU - Rashti, Farzin

AU - Kumar, Anjali S.

AU - Olden, Kevin W.

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N2 - 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. 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). 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.

AB - 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. 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). 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.

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KW - Difficult to sedate

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