Avoiding intravenous sedation allows patients to drive following the examination and eliminates the need for a second person to accompany the patient to the examination. TNE procedures do not always result in complete upper endoscopy examinations, because a patient who is not sedated may not tolerate passage of the endoscope through the entire stomach, the duodenal bulb, and the second portion of the duodenum.
“Unsedated small-caliber TNE offers the possibility of efficient and accurate endoscopic assessment of the esophagus with less cost and fewer risks compared with sedated upper endoscopy. The sensitivity of detecting esophageal abnormalities with unsedated small-caliber TNE is comparable to that of conventional upper endoscopy," said study lead author Blair Jobe, MD, University of Pittsburgh Medical Center, Pittsburgh, Penn.
“Studies in North America have been limited by small sample sizes and have been performed in populations selected for esophageal symptoms," Jobe continued. "These highly selected populations in referral settings have limited our ability to adequately risk stratify esophageal adenocarcinoma to achieve early detection and cure. Our study demonstrates that unsedated transnasal endoscopy is both feasible and safe in a primary care population, achieving short procedure times, a high diagnostic yield, and minimal anxiety. Patients reported good acceptability and minimal discomfort. These results suggest that we can now lower the threshold for endoscopic esophageal screening and with less cost."