KMID : 1188320230170030382
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Gut and Liver 2023 Volume.17 No. 3 p.382 ~ p.388
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Four-Hour Fasting for Semifluids and 2-Hour Fasting for Water Improves the Patient Experience of Esophagogastroduodenoscopy: A Randomized Controlled Trial
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Meng-Xi Cai
Ye Gao Li Li Wen Feng Yi-Lin Wang Zhao-Shen Li Lei Xin Luo-Wei Wang
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Abstract
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Background/Aims: We aimed to investigate the comfort, safety, and endoscopic visibility during esophagogastroduodenoscopy (EGD) afforded by a modified 4-hour semifluid and 2-hour water (¡°4+2¡±) fasting protocol.
Methods: In this parallel group, endoscopist-blinded, randomized controlled trial, outpatients undergoing unsedated diagnostic EGD from 10:30 AM to 12:00 PM were randomly assigned to either a ¡°4+2¡± protocol group or a conventional fasting group. The participants¡¯ comfort during the fasting period and procedure was measured using the visual analog scale, and mucosal visibility was measured by endoscopists using the total visibility score. Satisfaction was defined as a visual analog scale score of ¡Â3. The primary outcome was the participants¡¯ comfort during fasting.
Results: One hundred and six and 108 participants were randomized to the ¡°4+2¡± protocol and control groups, respectively. Participants¡¯ comfort before EGD was significantly higher in the ¡°4+2¡± protocol group measured by both the proportion of satisfaction (86.8% vs 63.9%, p=0.002) and the visual analog scale score (median [interquartile range]: 1.0 [1.0?2.0] vs 3.0 [1.0?4.0], p<0.001). The proportion of satisfaction during EGD also significantly improved (59.4% vs 45.4%, p=0.039) in the ¡°4+2¡± protocol group. The total visibility score was unaffected by the fasting protocol (5.0 [4.0?5.0] vs 4.0 [4.0?5.0], p=0.266). No adverse events were observed during the study.
Conclusions: The ¡°4+2¡± protocol was more comfortable and provided equal mucosal visibility and safety compared with conventional fasting for unsedated EGD.
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KEYWORD
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Esophagogastroduodenoscopy, Fasting, Patient comfort, Quality of health care
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