Authors: (including presenting author): :
Lau YL, So YW, Luk PF, Woo YP, Pang HN, Yuen KH
Affiliation: :
Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital
Keyword 2: :
Oesophago-gastro-duodenoscopy (OGD)
Introduction: :
Oesophago-gastro-duodenoscopy (OGD) is commonly performed for the investigation of gastrointestinal symptoms (particularly dyspepsia), and patients often experience significant discomfort during the procedure. While intravenous conscious sedation is routinely administered for colonoscopy, it is not a standard practice for OGD in public hospitals. The efficacy and safety of intravenous conscious sedation for OGD remain unknown.
Objectives: :
To evaluate patients’ experience and choice of intravenous conscious sedation for OGD, and its safety profile.
Methodology: :
Conscious sedation was offered to all patients undergoing elective outpatient OGD in TWEH from 3-December-2024 to 23-December-2025. Intravenous midazolam was administered prior to OGD for patients who opted for sedation, and they were then monitored by endoscopy nurses at the recovery area in endoscopy unit after OGD until they regained full consciousness and were physically fit for discharge. Patients were asked to fill in a questionnaire, focusing on overall experience (measured by 5-point Likert scale) and sedation choice. Any cardiopulmonary adverse events were also recorded.
Result & Outcome: :
One hundred and twenty-seven patients (median age 67) underwent elective OGD during the study period, and ninety-four (74.0%) opted for intravenous conscious sedation. The median dosage of Midazolam administered was 3mg. The majority (90.4%) of patients reported either very good (46) or good (39) overall experience with sedation given, while the remaining 9.6% reported satisfactory experience. Amongst the 54 patients with OGD done before without sedation, 45 (83.3%) reported better experience with sedation this time, while the remaining 16.7% reported similar experience. Amongst the 94 patients with OGD done, no cardiopulmonary adverse events were noted in the majority (95.7%). Four (4.3%) developed mild desaturation requiring transient low flow oxygen supplementation via nasal cannula, and were able to wean off shortly afterwards. No hypotensive episodes were noted, nor were reversal agents needed. All patients were discharged uneventfully. The median time from sedation administration to discharge was approximately two hours (122 minutes). Nearly all (98.9%) patients who underwent sedation this time wished to have OGD done under sedation again in the future. We conclude that intravenous conscious sedation with Midazolam effectively enhances patient experience during OGD, and is safe and well-tolerated. Intravenous conscious sedation can be universally offered to patients undergoing elective OGD, especially in non-acute clinical settings.
