# Ondasetron as Premedication for Unsedated Upper Digestive Endoscopy: A Cross‐Sectional Study Assessing Tolerance and Acceptability

## TL;DR

This study shows that using ondansetron as premedication allows most patients to tolerate unsedated upper digestive endoscopy well, especially when the procedure starts smoothly.

## Contribution

Demonstrates the feasibility of unsedated endoscopy in low-income settings using ondansetron premedication and highlights factors influencing patient tolerance.

## Key findings

- 91.72% of patients tolerated unsedated endoscopy well with ondansetron premedication.
- Ease of endoscope insertion was the primary determinant of good tolerance (adjusted OR 44.34).

## Abstract

In many low‐income countries, gastroduodenal endoscopy under conscious sedation remains uncommon due to added costs and concerns about managing complications and side effects. This study aimed to assess the feasibility of performing the procedure without sedation, using a potent antinauseant as premedication.

We conducted a prospective, single‐center study between 2020 and 2022 in Bukavu, eastern Democratic Republic of the Congo. Endoscopies were performed without sedation, supplemented by a protocol involving sublingual ondansetron spray. Clinical outcomes, procedural data, and patient feedback before and after the procedure were analyzed.

A total of 145 patients were enrolled, including 76 men (52.4%). Only 12 patients (8.28%) reported poor tolerance. The majority (91.72%) tolerated the procedure well, especially those who followed instructions and for whom endoscope insertion was straightforward (p < 0.001). Multivariate analysis identified ease of endoscope insertion as the primary determinant of tolerance (adjusted OR 44.34 [2.78–708.22], p = 0.007).

Performing upper digestive endoscopy without sedation, but with ondansetron premedication, is generally well tolerated. Successful tolerance depends on thorough patient preparation and careful execution of the initial stages of the procedure.