Use of audiovisual devices in transnasal endoscopy without sedation to improve tolerance. A prospective clinical trial.

J A González-González, D E Benavides-Salgado, D Garcia-Compean, B González-Gómez, J M Muñoz-Ayala, R A Jiménez-Castillo, H R Ibarra-Sifuentes, A Atilano-Díaz, J Sordia-Ramírez, M D Ramos-Cuevas, H J Maldonado-Garza
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Abstract

Introduction and aim: Transnasal endoscopy (TNE) has proven its diagnostic utility, but it has not been widely accepted given that it is performed without sedation. There are no previous studies on the use of methods to improve its tolerability. Our aim was to evaluate the tolerability of TNE, when simultaneously performed with an audiovisual device as a distractor.

Methods: We evaluated 50 patients, 10 of whom did not agree to participate. The performance of the procedure was explained, using an audiovisual device. Before randomization, we applied anxiety and depression scores. Patients were divided into 2 groups: Group I (using an audiovisual device during the procedure) and Group II (without a device). Anxiety and numeric pain rating scales were used, and vital signs were monitored and recorded before, during, and after the endoscopy. An overall procedure satisfaction score was applied at the end of the study and 24 h later.

Results: Mean age was 41.6 years and 35 of the patients were women (87.5%). The most frequent indication for TNE was refractory gastroesophageal reflux disease. There were no severe comorbidities, and none of the patients had a significant anxiety or depression score. One patient in Group II did not tolerate TNE due to nasal pain. There was no statistically significant difference between groups, regarding anxiety, pain, vital signs, and satisfaction scale.

Conclusion: Our study showed that TNE was well tolerated and had a high acceptance rate in our patients. The use of distracting audiovisual devices did not increase tolerance to the endoscopic procedure.

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在不使用镇静剂的经鼻内窥镜检查中使用视听设备以提高耐受性。前瞻性临床试验。
简介和目的:经鼻内窥镜检查(TNE)已被证明具有诊断作用,但由于其无需镇静剂,因此尚未被广泛接受。目前还没有关于如何提高其耐受性的研究。我们的目的是评估 TNE 同时使用视听设备分散注意力时的耐受性:我们对 50 名患者进行了评估,其中 10 人不同意参与。我们使用视听设备对手术过程进行了解释。随机分组前,我们对患者进行了焦虑和抑郁评分。患者被分为两组:第一组(手术过程中使用视听设备)和第二组(不使用视听设备)。我们使用了焦虑和数字疼痛评分量表,并在内窥镜检查之前、期间和之后监测和记录了生命体征。在研究结束时和 24 小时后对手术的总体满意度进行评分:平均年龄为 41.6 岁,35 名患者为女性(87.5%)。TNE最常见的适应症是难治性胃食管反流病。患者没有严重的合并症,也没有明显的焦虑或抑郁评分。第二组中有一名患者因鼻腔疼痛而无法忍受 TNE。在焦虑、疼痛、生命体征和满意度量表方面,组间差异无统计学意义:我们的研究表明,患者对 TNE 的耐受性良好,接受率较高。使用分散注意力的视听设备并不会增加患者对内窥镜手术的耐受性。
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