A COMPARATIVE-STUDY OF UNSEDATED TRANSNASAL ESOPHAGOGASTRODUODENOSCOPY AND CONVENTIONAL EGD

Background: A significant portion of the cost and complications associ ated with conventional esophagogastroduodenoscopy (EGD) is attributed to conscious intravenous sedation, which usually results in loss of wo rk on the day of the endoscopy. Earlier studies have described the fea sibility and safety of unsedated transnasal EGD in normal volunteers. Methods: We compared the diagnostic yield and patient acceptability of this new technique performed first, with conventional EGD performed s econd in 24 outpatients. Results: The sensitivity of transnasal EGD wa s 89% and its specificity was 97%. Transnasal EGD was more acceptable and less stressful to the patients than conventional EGD (p < 0.05). O xygen saturation and blood pressure did not change during transnasal E GD. Conclusion: Transnasal EGD is feasible, safe, and well tolerated b y patients. Specificity of transnasal EGD is similar to, but its sensi tivity is lower than, conventional EGD, By eliminating the need for se dation-related work loss and postprocedural monitoring, transnasal EGD potentially is more cost-effective than conventional EGD.