Anesthesia for Gastrointestinal Endoscopy from 2005 - 2006 in Siriraj Hospital : A Prospective Study

Background : Gastrointestinal endoscopy is a procedure for diagnosis and treatment of GI abnormalities. It is one of the most common interventional medical procedures performed throughout the world. The authors studied anesthetic data as a basis for further research. Objective : To report and evaluate the choices and techniques, drug usuage and complications of anesthesia for GI endoscopy from 2005-2006 in Siriraj Hospital. Method : Prospectively analyzed the patients on whom GI endoscopy had been performed during the period of October, 2005 to September, 2006 in Siriraj GI Endoscopy Center. The patients ̓characteristics, preanesthetic problems, anesthetic techniques, agents, time, and complications, as well as endoscopic procedures were assessed and summarized by using descriptive statistics. Results : During the study period there were 7,854 cases and 8,589 endoscopic procedures ; i.e. esophagogastroduodenoscopy (53.9%), colonoscopy (28.2%), endoscopic retrograde cholangiopancreatography (9.6%), sigmoidoscopy (4.0%), proctoscopy (1.9%) and others. The majority of them were in the age group of 51-60 years (22.8%) and classified in ASA class II (45.6%). The diagnosis were dyspepsia (19.8%), upper gastrointestinal hemorrhage (14.0%), CA colon (7.2%), gastritis (6.0%), bowel habit change (5.6%), lower gastrointestinal hemorrhage (4.5%) and others. Most common preanesthetic problems were hypertension (24.7%), hematologic disease (15.7%), diabetes mellitus (14.9%) and cardiovascular disease (10.8%). Topical pharyngeal anesthesia (52.0%) and intravenous sedation (39.5%) were the main anesthetic techniques. The mainly used anesthetic agents were lidocaine, propofol, fentanyl and midazolam. The anesthetic duration ranged from 5 to 210 minutes. The overall complication rate was 31.2%. Hypotension (13.8%) was the most frequent anesthetic complication. Conclusion : Almost all of the GI endoscopic procedures, topical anesthesia and intravenous sedation can be used effectively. However, clinical signs should be carefully observed and the anesthetic personnel had to optimize the patientʼs condition for safety and beware of complications.