Clinical Endoscopy

Original Article

Efficacy and Safety of Etomidate in Comparison with Propofol or Midazolam as Sedative for Upper Gastrointestinal Endoscopy: Jae Hyun Kim, Sanghwan Byun, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Moo In Park, Won Moon, Seun Ja Park; Clin Endosc 2020;53(5):555-561. Published online March 31, 2020; DOI: https://doi.org/10.5946/ce.2019.210

Background
/Aims: In this study, we compared the efficacy and safety of etomidate with those of propofol or midazolam for the maintenance of sedation during endoscopy.
Methods
The study enrolled patients who underwent sedative endoscopy in our hospital and divided them into three groups. Patients in each group were administered midazolam as induction therapy and were subsequently administered either midazolam (M + M group), propofol (M + P group), or etomidate (M + E group) as maintenance medication. The primary outcome was overall cardiovascular and respiratory adverse events.
Results
In total, 105 patients who underwent sedative endoscopic examination were enrolled. The outcomes related to the procedure and sedation were not significantly different among the groups. Overall cardiovascular and respiratory adverse events were observed in 9 patients (25.7%) in the M + M group, 8 patients (23.5%) in the M + P group, and 10 patients (27.8%) in the M + E group. The logistic regression analysis revealed that etomidate use was not an independent risk factor for overall cardiovascular and respiratory adverse events.
Conclusions
The outcomes following the use of etomidate for maintenance after induction with midazolam for sedation in upper gastrointestinal endoscopy were not inferior to those following midazolam or propofol use from the perspectives of safety and efficacy.

Citations

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Methoxyethyl Etomidate Hydrochloride (ET‐26): A Phase I Clinical Trial Assessing Drug–Drug Interactions in Healthy Subjects
Fan Yang, Pan‐Pan Ye, Wen‐Shuo Lv, Li‐Ze Li, Bao‐Zhong Zhao, John van denAnker, Xin‐Mei Yang, Lin‐Lin Song, Xiao‐Ran Yang, Yi Zheng, Bo‐Wen Ke, Wei Zhao
The Journal of Clinical Pharmacology.2025;[Epub] CrossRef
Comparison of ciprofol–alfentanil and propofol–alfentanil sedation during bidirectional endoscopy: A prospective, double-blind, randomised, controlled trial
Jiqiang Zhang, Ruijuan Liu, Ruirui Bi, Xia Li, Mengjun Xu, Lijuan Li, Yuxi su, Wenjun Yan
Digestive and Liver Disease.2024; 56(4): 663. CrossRef
Effects of Earmuffs and Eye Masks on Propofol Sedation during Spinal Anesthesia for Orthopedic Surgery: A Randomized Controlled Trial
Jin-Woo Park, Sung Il Bae, Jungyul Ryu, Seung Hyun Chung, Sang-Hwan Do
Journal of Clinical Medicine.2023; 12(3): 899. CrossRef
Effect of intravenous anesthesia by etomidate in combination with propofol on gastrointestinal endoscopy
Bo CHEN, Ke ZHANG, Mingshuai YU
Minerva Surgery.2023;[Epub] CrossRef
New sedatives and analgesic drugs for gastrointestinal endoscopic procedures
Jae Min Lee, Yehyun Park, Jin Myung Park, Hong Jun Park, Jun Yong Bae, Seung Young Seo, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Jun Kyu Lee, Byung-Wook Kim
Clinical Endoscopy.2022; 55(5): 581. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef
Comparative Safety Profiles of Sedatives Commonly Used in Clinical Practice: A 10-Year Nationwide Pharmacovigilance Study in Korea
Yeo-Jin Choi, Seung-Won Yang, Won-Gun Kwack, Jun-Kyu Lee, Tae-Hee Lee, Jae-Yong Jang, Eun-Kyoung Chung
Pharmaceuticals.2021; 14(8): 783. CrossRef
Physical and Chemical Compatibility of Etomidate and Propofol Injectable Emulsions
Chunling Wang, Shengnan Wang, Cuishuan Wu, Li Lei, Dong-Xin Wang, Qiang Zhang
Pharmacology.2021; 106(11-12): 644. CrossRef

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Commentary

When Should We Perform Endoscopy for Patients with Upper Gastrointestinal Bleeding?: Kyoungwon Jung, Moo In Park; Clin Endosc 2019;52(1):1-2. Published online January 17, 2019; DOI: https://doi.org/10.5946/ce.2019.007

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Original Articles

Effect of Sending Educational Video Clips via Smartphone Mobile Messenger on Bowel Preparation before Colonoscopy: Sung Chan Jeon, Jae Hyun Kim, Sun Jung Kim, Hye Jung Kwon, Youn Jung Choi, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park; Clin Endosc 2019;52(1):53-58. Published online August 29, 2018; DOI: https://doi.org/10.5946/ce.2018.072

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Background
/Aim: We aimed to evaluate the efficacy of sending educational video clips via smartphone mobile messenger (SMM) on enhancing bowel preparation before colonoscopy.
Methods
This was a prospective, endoscopist-blinded, randomized controlled study. Patients in the SMM group received two video clips sent via SMM that explained the diet and regimen for bowel preparation, whereas those in the control group did not receive any video clips. We compared the quality of bowel preparation between the two groups, which was assessed by an endoscopist using the Ottawa scale.
Results
Between August and November 2014, 140 patients in the SMM group and 141 patients in the control group underwent colonoscopic examination. The total Ottawa score of the SMM group was significantly lower than that of the control group (5.47±1.74 vs. 5.97±1.78, p=0.018). These results were particularly prominent in the younger age group; the total Ottawa score of patents in the SMM group aged <40 years was significantly lower than that of patients in the control group aged <40 years (5.10±1.55 vs. 6.22±2.33, p=0.034).
Conclusions
We demonstrated that sending educational video clips via SMM could result in better bowel preparation, especially in the younger age group.

Citations

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Peng Li, Xueqian He, Xufang Yang, Jing Du, Weiquan Wu, Jiangfeng Tu
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Tatiane Santa Rosa Diniz, Suzimar de Fátima Benato Fusco, Maria Elizandre Camilo de Oliveira, Hélio Rubens de Carvalho Nunes, Marla Andréia Garcia de Avila
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Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image: Eun Jeong Gong, Jeong Hoon Lee, Kyoungwon Jung, Charles J. Cho, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim; Clin Endosc 2017;50(3):261-269. Published online August 22, 2016; DOI: https://doi.org/10.5946/ce.2016.056

Abstract PDF PubReader ePub

Background
/Aims: The detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.
Methods
A total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.
Results
Simultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.
Conclusions
Lesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.

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Review

Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer: Kyoungwon Jung, Moo In Park, Sung Eun Kim, Seun Ja Park; Clin Endosc 2016;49(4):336-345. Published online July 25, 2016; DOI: https://doi.org/10.5946/ce.2016.057

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Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic and pathological differences is necessary, especially for LP type GCs in the developmental stage. In conclusion, diagnosis of pre-stage or latent LP type GC before progression to typical LP type GC requires the detection of IIc-like lesions in the fundic gland area. It is also crucial to identify any abnormalities such as sclerosis of the gastric wall and hypertrophy of the mucosal folds during endoscopy.

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