Lee Rose, Oparaugo Yonna, Mackensen Molly, Vaidy Katherine
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics Medical College of Wisconsin Milwaukee Wisconsin USA.
JPGN Rep. 2025 Jun 11;6(3):215-218. doi: 10.1002/jpr3.70047. eCollection 2025 Aug.
Sedation-free transnasal endoscopy (TNE) is a safe, feasible, and well tolerated procedure performed in children to evaluate the upper gastrointestinal tract. The procedural technique of TNE in children is adopted from procedural standards in adults, typically using the upright seated position. The left lateral decubitus (LLD) position may be preferred for optimal safety and visualization during TNE. This pilot study explored the feasibility and tolerance of TNE in pediatric patients using the LLD position.
This was a retrospective review of 13 children who underwent sedation-free TNE in the LLD position from October 2024 to February 2025 in an outpatient gastroenterology procedure suite. Procedure time, patient tolerance (TNEase score), adverse events, and patient demographics were collected and analyzed.
A total of 13 TNE procedures were successfully completed in the LLD position. The mean (standard deviation (SD)) age of the cohort was 12 years (2.7); 38% were female. The mean (SD) procedural time for esophagoscopy was 5.1 min (1.6). All patients had TNEase score of 2 or lower. Ten (77%) of patients had a TNEase score of 1. Two patients with history of anxiety and orthostasis experienced syncope in the upright seated position but subsequently completed the TNE in the LLD position without adverse events.
LLD position for sedation-free TNE is feasible and well tolerated in children. Findings should prompt further, prospective investigations of the benefits of LLD versus upright seated position, particularly in children with orthostatic intolerance.
无镇静经鼻内镜检查（TNE）是一种在儿童中进行的安全、可行且耐受性良好的用于评估上消化道的检查方法。儿童TNE的操作技术借鉴了成人的操作标准，通常采用直立坐姿。左侧卧位（LLD）在TNE过程中可能因最佳的安全性和视野而更受青睐。这项前瞻性研究探讨了在儿科患者中采用LLD位进行TNE的可行性和耐受性。
这是一项对2024年10月至2025年2月在门诊胃肠病学操作室采用LLD位进行无镇静TNE的13名儿童的回顾性研究。收集并分析了操作时间、患者耐受性（TNEase评分）、不良事件和患者人口统计学数据。
共成功在LLD位完成了13例TNE操作。该队列的平均（标准差）年龄为12岁（2.7）；38%为女性。食管镜检查的平均（标准差）操作时间为5.1分钟（1.6）。所有患者的TNEase评分为2或更低。10名（77%）患者的TNEase评分为1。两名有焦虑和直立不耐受病史的患者在直立坐姿时出现晕厥，但随后在LLD位完成了TNE，无不良事件。
在儿童中，LLD位用于无镇静TNE是可行的且耐受性良好。这些发现应促使对LLD位与直立坐姿的益处进行进一步的前瞻性研究，特别是在直立不耐受的儿童中。
