Despite the fact that pre-medication, in a number of different drug combinations, has been used for a long time in endoscopy units, and has been subject to extended clinical studies, it is still not possible to claim that it has attained an ideal state with regard to patient tolerance to endoscopy procedures. In this clinical study, we have investigated the effects of psychological intervention in addition to medication, which we used on patients with intolerance to endoscopy. Intolerance was very high in all endoscopic procedures (15.8% total). It was observed that average midazolam doses were significantly higher in intolerant than in tolerant patients. It was found that in patients who had received psychiatric intervention, the decrease in midazolam dose was statistically significant in a subsequent endoscopy procedure.
Al-AtrakchiHA: Upper gastrointestinal endoscopy without sedation: a prospective study of 2000 examinations. Gastrointest Endosc1989; 35: 79–81
2.
FisherNCBaileySGibsonJA: A prospective, randomized controlled trial of sedation vs. no sedation in outpatient diagnostic upper gastrointestinal endoscopy. Endoscopy1998; 30: 21–24
3.
CampoRBrulletEMontserratACalvetXRiveroEBrotonsC: Topical pharyngeal anesthesia improves tolerance of upper gastrointestinal endoscopy: a randomized double-blind study. Endoscopy1995; 27: 659–664
4.
LeitchDGWicksJel BeshirOAAliSAChaudhuryBK: Topical anesthesia with 50 mg of lidocaine spray facilitates upper gastrointestinal endoscopy. Gastrointest Endosc1993; 39: 384–387
5.
FroehlichFSchwizerWThorensJKohlerMGonversJJFriedM: Conscious sedation for gastroscopy: patient tolerance and cardiorespiratory parameters. Gastroenterology1995; 108: 697–704
6.
CantorDSBaldridgeET: Premedication with meperidine and diazepam for upper gastrointestinal endoscopy precludes the need for topical anesthesia. Gastrointest Endosc1986; 32: 339–341
7.
DaneshmendTKBellGDLoganRF: Sedation for upper gastrointestinal endoscopy: results of a nationwide survey. Gut1991; 32: 12–15
8.
ChokhavatiaSNguyenLWilliamsRKaoJHeavnerJE: Sedation and analgesia for gastrointestinal endoscopy. Am J Gastroenterol1993; 88: 393–396
9.
ArenaJGHightowerNEChongGC: Relaxation therapy for tension headache in the elderly: a prospective study. Psychol Aging1988; 3: 96–98
10.
LoewTHSohnRMartusPTrittKRechlinT: Functional relaxation as a somatopsychotherapeutic intervention: a prospective controlled study. Altern Ther Health Med2000; 6: 70–75
11.
JordanABendixTNielsenHHansenFRHostDWinkelA: Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective, single-blinded, randomized clinical trial. Spine1998; 1: 311–318
12.
SeersKCarrollD: Relaxation techniques for acute pain management: a systematic review. J Adv Nurs1998; 27: 466–475
13.
ChlanLEvansDGreenleafMWalkerJ: Effects of a single music therapy intervention on anxiety, discomfort, satisfaction, and compliance with screening guidelines in outpatients undergoing flexible sigmoidoscopy. Gastroenterol Nurs2000; 23: 148–156
14.
ColtHGPowersAShanksTG: Effect of music on state anxiety scores in patients undergoing fiberoptic bronchoscopy. Chest1999; 116: 819–824
15.
LalunaLAllenMLDimarinoAJ: The comparison of midazolam and topical lidocaine spray versus the combination of midazolam, meperidine, and topical lidocaine spray to sedate patients for upper endoscopy. Gastrointest Endosc2001; 53: 289–293
16.
LazzaroniMPorroGB: Preparation, premedication, and surveillance. Endoscopy2001; 33: 103–108
17.
SalmoreRGNelsonJP: The effect of preprocedure teaching, relaxation instruction, and music on anxiety as measured by blood pressures in an outpatient gastrointestinal endoscopy laboratory. Gastroenterol Nurs2000; 23: 102–110
18.
YalomID: The theory and practice of group psychotherapy. In: The Therapeutic Factors in Group Therapy, 3rd edn (YalomID, ed). New York: Basic Books, 1988; pp7–8
19.
RistikankareMHartikainenJHeikkinenMJanatuinenEJulkunenR: Is routinely given conscious sedation of benefit during colonoscopy?Gastrointest Endosc1999; 49: 566–572
20.
BarawiMGressF: Conscious sedation: is there a need for improvement?Gastrointest Endosc2000; 51: 365–368
21.
ReyJF: Sedation for gastrointestinal endoscopy: as much as possible, or without?Endoscopy1996; 28: 308–309
