Unsedated small-caliber esophagogastroduodenoscopy (EGD) - Less expensive and less time-consuming than conventional EGD

Background: A significant portion of the costs and complications of esophag ogastroduodenoscopy (EGD) are related to the use of sedation. The feasibili ty and tolerability of small-caliber EGD (seEGD) without sedation has been evaluated; however, there is limited data concerning times and costs associ ated with this procedure as compared with conventional EGD (cEGD) with seda tion. Study. Sixteen patients underwent scEGD with the Pentax EG-1840 (outs ide diameter, 6 mm) without sedation. A control group of 16 patients was ma tched for age, sex, day, and indication of procedure. The time of procedure , time in procedure room, time in recovery room, and procedure costs were d etermined in both the study and control groups. After the procedure, scEGD patients completed surveys consisting of visual-analogue scales to assess t olerance and preferences regarding sedation for future procedures. Results: Procedure time, procedure room time, and recovery room time was 5.2, 16.3, and 9 minutes for scEGD and 13.5, 34.9, and 41.3 minutes for cEGD, respect ively (p < 0.001 for all comparisons). The mean cost of scEGD, excluding ph ysician fees, was $462.00, which was significantly lower than the $587.00 f or cEGD (p < 0.001). Survey results revealed good tolerance for the unsedat ed procedure. Conclusions: Unsedated scEGD was well tolerated and resulted in a shorter time of procedure, less time spent in procedure room, reduced recovery room time, and lower costs as compared with cEGD with sedation.