ENDOSCOPY - THROAT SPRAY OR SEDATION

Anxious patients tolerate endoscopy poorly. It was proposed that such patients might derive most benefit from sedation, while most non-anxio us patients would prefer endoscopy with lignocaine throat spray alone. In a prospective study, 200 out-patients underwent diagnostic endosco py after receiving one of two detailed information sheets which offere d them either the choice between spray or sedation (n = 100) or the sa me choice but encouraged those who were anxious about endoscopy to cho ose sedation (n = 100). When given an informed choice, most non-anxiou s patients prefer not to be sedated during diagnostic endoscopy. If pa tients who are anxious about the procedure are advised to choose sedat ion, those who nevertheless opt for topical throat spray alone find th e endoscopy just as comfortable. If the endoscopy were to be repeated, 73% of the spray group and 77% of the sedation group would make the s ame choice again. Of 33 patients who chose spray but had been given on ly sedation for a previous endoscopy, 26 (79%) would choose spray agai n for a future endoscopy. The choice of spray or sedation should refle ct the patient's view as well as that of the endoscopist.