Endoscopic Gastric Examination: Sedation Approach

EGD was performed by 14 experienced endoscopists. EGD was performed as a screening method during a health evaluation, for follow-up of gastritis and/or gastric tumor, for the examination for abdominal symptoms, to investigate an abnormality of photofluorography, to examine abnormal serum pepsinogen levels, or due to a positive finding of H. pylori antibody. The pharynx of the patients was topically anesthetized with a gargle of lidocaine hydrochloride 2% viscous solution (Xylocaine^® Viscous 2%; AstraZeneca Inc., Cambridge, UK) before the EGD.^{(7 )} The endoscopists were allowed to use their clinical judgement to decide the amount and type of sedative and analgesic medication and the antagonist—midazolam (0–10 mg), pethidine (0–70 mg), flumazenil (0–0.5 mg) and naloxone (0–0.4 mg)—to be used. Following the EGD, the patients were transferred to the recovery room. All adverse events including nausea and vomiting were evaluated by the recovery room nurse. Patients were requested to return 10 to 14 days later for the explanation of their EGD results and were also interviewed regarding any additional adverse events.