Endoscopy 2025; 57(S 02): S302
DOI: 10.1055/s-0045-1805738
Abstracts | ESGE Days 2025
ePosters

Efficacy of non-pharmacological techniques or adjuncts to sedation administration for gastrointestinal endoscopic procedures: a systematic review and meta-analysis

Authors

  • P Roelandt

    1   Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
    2   Endoscopy Unit, University Hospitals Leuven, Leuven, Belgium

  • G Tziatzios

    3   Department of Gastroenterology, General Hospital of Nea Ionia “Konstantopoulio-Patision”, Athens, Greece

  • N De Leebeeck

    2   Endoscopy Unit, University Hospitals Leuven, Leuven, Belgium

  • K Triantafyllou

    4   National and Kapodistrian University of Athens, Athens, Greece
Further Information
Also available at
 

Aims To assess the efficacy of non-pharmacological techniques such as acupuncture, virtual reality (VR) and/or music as alternatives or adjuncts to sedation administration for gastrointestinal (GI) endoscopic procedures a systematic review and meta-analysis was performed.

Methods A systematic review across MEDLINE and Cochrane central register for randomized controlled trials (RCTs) between 2014 and 2024 was performed, evaluating the efficacy of non-pharmacological techniques such as acupuncture, virtual reality (VR) and/or music as alternatives or adjuncts to sedation administration for GI endoscopic procedures. Primary outcome was reported pain, while anxiety and satisfaction comprised the secondary ones. Pairwise meta-analyses was performed, presented as the effect size on study outcomes either as Risk Ratio (RR) or Mean Difference (MD) with 95% confidence interval (CI). The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results Twenty-three RCTs involving 2243 patients (non-pharmacological techniques 1130, standard sedation 1113) were included. Compared to the standard sedation group, overall application of non-pharmacological techniques resulted in significantly lower pain [MD (95%CI)=-1.39 (-1.80 – 0.98); Ι2=68%] and anxiety [MD=-4.78, 95% CI (-7.34, -2.23); Ι2=90%], while satisfaction was higher [MD=1.90, 95% CI (0.84, 2.96), Ι2=93%]; there was moderate confidence in estimates. This effect regarding reported pain was consistent for virtual reality (7 RCTs, n=523) and music (12 RCTs, n=1365) [MD=-1.22, 95% CI (-1.65, -0.79); I2=9% and MD=-1.45, 95% CI (-2.04, -0.85), I2=80%; respectively), while in contrast the difference regarding acupuncture (4 RCTs, n=325) did not reach significance [MD=-1.63, 95% CI (-3.37, 0.12), I2=38%].

Conclusions Concomitant application of non-pharmacological techniques (acupuncture, virtual reality and/or music) or adjuncts to sedation administration for GI endoscopic procedures reduce pain and anxiety improving at the same time patient satisfaction.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany