Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Objectıves: Esophagoduodenoscopy (EDS) and colonoscopy can be done as bidirectional endoscopy in the same session. The aim of this study was to compare anesthetic requirements and hemodynamical effects in EDS or colonoscopy first done for bidirectional endoscopy. Materıals & Methods: After approvalof local ethical committee and obtaining informed consent, 80 patients aged 18-70 years, ASA I-III were included randomly into this study. The patients were allocated into two groups: GroupC: First colonoscopy followed by EDS. GroupE: First EDS followed by colonoscopy. All patients received standard anesthesia with 1μg.kg-1 fentanyl and 1mg.kg-1 propofol. Demographical variables, Heart rate (HR), pulse oximetry (SpO2) and Ramsey Sedation Score(RSS) were recorded every 10 minutes. Total propofol consumption retching during EDS and time to reach cecum were also recorded. At the end of the procedure endoscopist and patient satisfaction were questioned. Results: Retching during EDS was not statistically significantly different in both groups. Total procedure durationand EDS duration was statistically meaningful longer in GroupE (p=0,028; p=0,016). Complication frequency was higher in GroupE (p=0,011). Beginning and 20th minute HR were statistically significant lower in GroupE (p=0,036; p=0,001). 5th minute RSS was lower and 10thminute RSS was higher in GroupE compared to GroupC (p=0,001; p=0,001). Endoscopist and patient satisfaction were lower in GroupE (p=0,049;p=0,001). There was no difference in time to reach cecum and recovering period. Additional propofol consumption was increased in GroupE (p=0,016). Conclusıon: Regarding to shorter procedural duration, lower consumption amount of propofol and fewer complications, it could be a beter choice to start the bidirectional procedure with colonoscopy first.

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