Patient preparation, sedation, and equipment used in pediatric gastrointestinal endoscopy in Japan

Specifications for patient preparation, sedation, and equipment used in pediatric gastrointestinal endoscopy in Japan are not well documented. Thus, the aim of this study was to investigate how Japanese pediatric endoscopy specialists perform gastrointestinal endoscopy in children. A questionnaire requesting information regarding patient preparation, sedation, and decisions regarding scope size used in esophagogastroduodenoscopy, colonoscopy, balloon enteroscopy, or endoscopic retrograde cholangiopancreatography, was sent to all 17 members of the Japanese Pediatric Gastrointestinal Endoscopy Guideline Committee. As a result, we received a response from all 17 members. General anesthesia was most frequently used as sedation in infants undergoing esophagogastroduodenoscopy; midazolam or general anesthesia was used at equivalent frequencies among infants undergoing colonoscopy. Peroral balloon enteroscopy was generally performed under general anesthesia even in adolescents; however, peranal balloon enteroscopy was performed under general anesthesia or midazolam sedation at equivalent frequencies. For preparation prior to esophagogastroduodenoscopy, topical lidocaine was used in adolescents, who did not receive general anesthesia. As preparation for colonoscopy, magnesium citrate and polyethylene glycol were widely used, often in combination with picosulfate sodium. These specialists decided the size of the scope to use according to the patient' s age, purpose of endoscopy, and body weight.