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


     

    Conflicts of interest

    Authors do not have any conflict of interest to disclose.

    Publication History

    Article published online:
    27 March 2025

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