Endoscopic Ultrasound without Sedation: A Feasibility Study from a Tertiary Care Center

Objective: EUS of the esophagus and stomach: under local anesthesia a feasibility study.

Background: This study was planned to study feasibility of diagnostic EUS via esophagus stomach.

Methods: A total of 101 patients were given lidocaine lozenge 20 minutes before and xylocaine spray 5 minutes before diagnostic EUS. Patients used a visual analogue scale to score pre-EUS anxiety and tolerance for the procedure. Endoscopists used a visual analogue scale to score ease of echoendoscope introduction and overall patient cooperation. Subsequent to EUS, patients were asked if they were willing to undergo the procedure under the same conditions.

Results: The patients’ visual analogue scale scores indicated tolerance for the introduction of the echoendoscope and the procedure overall. Overall, patient tolerance was predicted by sedation (p < 0.001) and pre-EUS anxiety (p = 0.024). EUS could completed in all patients. There was no significant difference in overall patient cooperation during the procedure. There were no significant differences in introduction time, total procedure time, or patients’ willingness to undergo the procedure under the same conditions.

Conclusions: EUS of the esophagus and stomach without intravenous sedation is feasible for endoscopists and patients with combination of lidocaine lozenges and xylocaine spray.

Table 1 Risk factors for post-ERCP pancreatitis

Patient-related	Percentage	Procedure-related	Percentage
Young age	21.8%	Difficult cannulation	0%
Female sex	60.3%	Number of cannulation attempts	0%
Suspected SOD dysfunction	0%	Pancreatic duct cannulation	4.9%
Prior post-ERCP pancreatitis	0%	Pancreatic duct injection	0%
Normal serum bilirubin	44.5%	Precut sphincterotomy	1%
Previous recurrent pancreatitis	0%	Ampullectomy	0%

Publication History

Article published online:
22 April 2024