The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
G. D. Bell - One of the best experts on this subject based on the ideXlab platform.
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Pattern of breathing during Upper Gastrointestinal Endoscopy: implications for administration of supplemental oxygen.
Alimentary pharmacology & therapeutics, 2007Co-Authors: G. D. Bell, J. H. L. Antrobus, J. Lee, T. Coady, A. MordenAbstract:SUMMARY Cardiopulmonary complications account for half the deaths associated with Upper Gastrointestinal Endoscopy. The incidence of hypoxia at the time of Upper Gastrointestinal Endoscopy can be greatly reduced by the administration of supplemental oxygen via nasal cannulae. Using dual thermistors in the mouth and nostrils of patients undergoing Upper Gastrointestinal Endoscopy, the present study demonstrates that most patients breathe predominantly via the oral, rather than the nasal, route following intubation of the oesophagus. The implication from the study is that, if supplemental oxygen is to be used in ‘at risk’patients, it would be logical to employ an oral, rather than nasal, route of administration.
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Review article: premedication and intravenous sedation for Upper Gastrointestinal Endoscopy
Alimentary pharmacology & therapeutics, 2007Co-Authors: G. D. BellAbstract:SUMMARY Upper Gastrointestinal Endoscopy can be performed without intravenous sedation but the evidence suggests that, in the United Kingdom and United States, most patients and endoscopists prefer that some form of premedication is given. Intravenous diazepam or midazolam are used by the majority of endoscopists. In the UK, the ratio of diazepam to midazolam users is approximately 2:1, while in the USA more endoscopists are now using midazolam. Midazolam is approximately twice as potent as diazepam but, when allowance is made for this, there is probably little or no difference in the propensity of the two drugs to produce respiratory depression. The antegrade amnesic effect of midazolam is significantly superior to that of diazepam. A benzodiazepine/narcotic combination can achieve a smoother and more rapid induction with less gagging and choking, but the incidence of adverse outcomes—particularly respiratory depression—is increased significantly. Over 50% of the deaths that are associated with Upper Gastrointestinal Endoscopy are due to cardiopulmonary problems. Hypoxia is very common if measured using non-invasive monitoring equipment, such as a pulse oximeter. Methods of preventing oxygen desaturation and thus, by inference, most cardiac arrhythmias associated with Endoscopy are discussed, as is the role of flumazenil, the new benzodiazepine antagonist.
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Prospective audit of perforation rates following Upper Gastrointestinal Endoscopy in two regions of England
The British journal of surgery, 1995Co-Authors: M A Quine, G. D. Bell, R. F. Mccloy, H. R. MatthewsAbstract:After cardiopulmonary complications, perforation is the second most important cause of complications following flexible Upper Gastrointestinal Endoscopy. A recent audit of 14,149 procedures detected a perforation rate of 0.05 per cent (overall mortality rate 0.008 per cent) during diagnostic Endoscopy, and a perforation rate of 2.6 per cent (overall mortality rate 1.0 per cent) following oesophageal intubation or dilatation. The incidence of perforation following both diagnostic and therapeutic Upper Gastrointestinal Endoscopy has not changed over the past 10 years. The risk factors are numerous but this audit demonstrated that inexperience increases the likelihood of perforation.
H. R. Matthews - One of the best experts on this subject based on the ideXlab platform.
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Prospective audit of perforation rates following Upper Gastrointestinal Endoscopy in two regions of England
The British journal of surgery, 1995Co-Authors: M A Quine, G. D. Bell, R. F. Mccloy, H. R. MatthewsAbstract:After cardiopulmonary complications, perforation is the second most important cause of complications following flexible Upper Gastrointestinal Endoscopy. A recent audit of 14,149 procedures detected a perforation rate of 0.05 per cent (overall mortality rate 0.008 per cent) during diagnostic Endoscopy, and a perforation rate of 2.6 per cent (overall mortality rate 1.0 per cent) following oesophageal intubation or dilatation. The incidence of perforation following both diagnostic and therapeutic Upper Gastrointestinal Endoscopy has not changed over the past 10 years. The risk factors are numerous but this audit demonstrated that inexperience increases the likelihood of perforation.
W. M. Shaikh - One of the best experts on this subject based on the ideXlab platform.
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Lidocaine toxicity in a student undergoing Upper Gastrointestinal Endoscopy.
Gut, 2000Co-Authors: Bader Faiyaz Zuberi, M. R. Shaikh, N.-u.-n. Jatoi, W. M. ShaikhAbstract:Background— A young medical student developed severe toxicity, including seizures, respiratory distress, hypotension, and asystole, and died after gargling with lidocaine before Upper Gastrointestinal Endoscopy. Upper Gastrointestinal Endoscopy is usually a safe outpatient procedure before which the throat is often anaesthetised. Case report— A 21 year old medical student presented with the symptoms of acid peptic disease and was referred for outpatient oesophagogastroduodenoscopy. He was of average build, did not smoke, and did not take any drugs; he had no history of …
M A Quine - One of the best experts on this subject based on the ideXlab platform.
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Prospective audit of perforation rates following Upper Gastrointestinal Endoscopy in two regions of England
The British journal of surgery, 1995Co-Authors: M A Quine, G. D. Bell, R. F. Mccloy, H. R. MatthewsAbstract:After cardiopulmonary complications, perforation is the second most important cause of complications following flexible Upper Gastrointestinal Endoscopy. A recent audit of 14,149 procedures detected a perforation rate of 0.05 per cent (overall mortality rate 0.008 per cent) during diagnostic Endoscopy, and a perforation rate of 2.6 per cent (overall mortality rate 1.0 per cent) following oesophageal intubation or dilatation. The incidence of perforation following both diagnostic and therapeutic Upper Gastrointestinal Endoscopy has not changed over the past 10 years. The risk factors are numerous but this audit demonstrated that inexperience increases the likelihood of perforation.
J G Freeman - One of the best experts on this subject based on the ideXlab platform.
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Throat spray for Upper Gastrointestinal Endoscopy is quite acceptable to patients.
Endoscopy, 1996Co-Authors: C C Tan, J G FreemanAbstract:Background and study aims The use of sedation in Upper Gastrointestinal Endoscopy is widespread, mainly because of the belief that patients are likely to tolerate the procedure better. The aim of the present study was to assess patients' response to the policy of actively persuading them to accept a throat spray for Upper Gastrointestinal Endoscopy. Patients and methods Three hundred patients who had recently undergone Endoscopy were sent a questionnaire; 244 of them responded (81%). Data on age, sex, procedure tolerance, anxiety levels, and future choice of sedation or throat spray for repeat procedures were sought. The results were analysed using the chi-squared test. Results One hundred and ninety-two (79%) chose, or were persuaded to have, throat spray, and only nine (5%) had to be transferred to sedation. Thirty-two percent of patients who had throat spray tolerated Endoscopy well, compared to 70% of those who chose sedation. One hundred and nineteen throat spray patients (62%) showed a low level of reluctance to undergo repeat Endoscopy, compared to 37 (71%) sedated patients (not significant). One hundred and forty-four throat spray patients (76%) expressed satisfaction with the throat spray, but if given a choice, only 124 (66%) would choose throat spray again. Male patients, those with lower anxiety levels, and those over 50 years old, tolerated Endoscopy with throat spray better, showed less reluctance to undergo repeat Endoscopy, and were more likely to choose throat spray again. Those who had any previous experience of Endoscopy under sedation were less likely to choose throat spray again. Conclusion The present study shows that the use of throat spray for diagnostic Endoscopy is quite acceptable to patients. For safety reasons, we should be encouraging greater use of throat spray in routine diagnostic Upper Gastrointestinal Endoscopy.
