Arterial oxygen saturation during upper gastrointestinal endoscopy: Influence of sedation and operator experience

Lavies, N.G.; Creasy, T.S.; Harris, Kenneth C.; Hanning, C.D.

doi:10.1016/0952-8180(95)93830-j

Cited by 17 publications

(26 citation statements)

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“…This can be attributed to its sedative and anti-anxiety properties. A favourable effect on patient tolerance has also been reported earlier [3,6]. We observed that SaO2 dropped just after the insertion of endoscope in both the groups.…”

Section: Parameters Studiedsupporting

confidence: 72%

“…However, the effect of sedation on SaO_ is still much debated. Some have reported that diazepam sedation led to greater falls in saturation, particularly during the intubation procedure, [4] while as, some feel that sedation by diazepam or midazolam did not induce further desaturation over their respective control groups [3,6,7]. These conflicting observations could be due to the result of the lack of well controlled time course studies as also the wide variety of sedatives use in the endoscopic procedures [3].…”

Section: Parameters Studiedmentioning

confidence: 63%

“…Several previous studies have shown that hypoxia occurs during EGD, which has been attributed variously to pre-treatment, the presence of [3,4,[6][7][8][9]. However, the effect of sedation on SaO_ is still much debated.…”

Section: Parameters Studiedmentioning

confidence: 98%

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Effect of Diazepam Sedation on Arterial Oxygen Saturation and Patient Tolerance During Esophagogastroduodenoscopy

Malik

Mubarik

Kadla

et al. 1997

Diagnostic and Therapeutic Endoscopy

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The impact of intravenous (I/V) diazepam sedation on arterial oxygen saturation (SaO2) and patient tolerance was studied in 100 patients in the age group of years, who were subjected to esophagogastroduodenoscopy (EGD) for different indications. Equal number of patients in the same age group, who did not receive the sedation acted as controls. It was observed that SaO2 showed a transient fall during the first few minutes of the endoscopic procedure even without sedation and diazepam administration did not significantly (p > 0.05) aggravate this oxygen desaturation. It was also observed that diazepam sedation increased the procedure tolerance of the patients when compared with controls (p < 0.01). In conclusion, it was inferred that I/V diazepam may act as a safe and favourable sedative for EGD.

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Section: Parameters Studiedsupporting

confidence: 72%

Section: Parameters Studiedmentioning

confidence: 63%

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Effect of Diazepam Sedation on Arterial Oxygen Saturation and Patient Tolerance During Esophagogastroduodenoscopy

Malik

Mubarik

Kadla

et al. 1997

Diagnostic and Therapeutic Endoscopy

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“…Others have shown that lower nadir saturations are associated with poor sedation, 24 increasing subject age, ~,26 bolus injection as opposed to slow injection 2s and operator experience. 24 In conclusion, we found no reason to support the routine use of midazolam/alfentanil in the doses studied for sedation during upper GI endoscopy. The cost of treatment for a subject between 50-99 kg in our study was C$3.20 for midazolam/alfentanil and C$0.44 for diazepam/meperidine.…”

Section: Discussionmentioning

confidence: 75%

Sedation for upper gastrointestinal endoscopy: a comparison of alfentanil-midazolam and meperidine-diazepam

1994

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The authors studied the efficacy and cost of substituting sedation using midazolam and alfentanil for the existing regimen of diazepam and meperidine in patients requiring upper gastrointestinal endoscopy. Sixty consenting subjects were randomized to receive either meperidine 50 mg with diazepam approximately 90 #g" kg -1 (Group 19) (0,4 + 0,6 vs 1,7 • 2,4, P < 0,005) Les auteurs comparent I'efficacit~ et le coCtt de la substitution du midazolam et de l'alfentanil utilis~s pour la s~dation it l'association courante de diazepam et de m~p~ridine chez des patients soumis it un endoscopie gastro-intestinale haute. Soixante aduhes consentants sont r~partis au hasard pour recevoir soit mdpdridine 50 mg avec diazepam 90 ~g" kg -t environ (groupe D) soit alfentanil 250 t~g avec 50 ~tg" kg -t environ de midazolam (groupe M). La temps requis pour d~ntroduction de

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“…This may be due to the fact that the myocardial oxygen demand is increased during endoscopy because of the increases in heart rate and cardiac load. Furthermore, myocardial ischemia is easily induced by decreases in SaO 2 [13]. Indirect measures including pulse rate, blood pressure, SaO 2 , and the electrocardiogram have been the major means of monitoring circulatory kinetics [14].…”

Section: Discussionmentioning

confidence: 99%

Effect of Upper Gastrointestinal Endoscopy on Circulation in the Elderly

Shimamoto

Hirata²,

Katsu³

1999

Gerontology

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Background: Upper gastrointestinal endoscopy in the elderly is increasingly becoming more common, despite the possibility that a minimal load on the circulation can cause serious complications such as shock and cardiac arrest. Objective: The effects of endoscopy on the heart and the possibility of predicting circulatory accidents were studied using natriuretic peptide levels. Methods: The patients were randomly chosen according to their age and divided into an elderly group (over 60 years of age, 64 patients) and a young group (under 30 years of age, 20 patients). The patients in the elderly group were further subdivided into two groups based on the presence or absence of circulatory complications (46 patients with circulatory complications and 18 without complications). The load on the heart was evaluated by measuring human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP) which are secreted by the myocardial cells in response to cardiac load. Specimens were obtained before and after endoscopy. Results: The hANP level was significantly higher after endoscopy in the elderly group, regardless of the presence or absence of circulatory complications. No significant difference was observed in the hBNP level. No significant increase in hANP or hBNP levels was observed after endoscopy in the young group. Conclusions: These observations suggest an increased atrial load during endoscopy in the elderly. The increase in pulse rate during endoscopy is one possible cause of atrial load. Therefore, the risk of circulatory system damage must be recognized when endoscopy is performed in the elderly. The measurement of plasma hANP and hBNP levels may provide effective indices for evaluating cardiac load during endoscopy.

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Arterial oxygen saturation during upper gastrointestinal endoscopy: Influence of sedation and operator experience

Cited by 17 publications

References 0 publications

Effect of Diazepam Sedation on Arterial Oxygen Saturation and Patient Tolerance During Esophagogastroduodenoscopy

Effect of Diazepam Sedation on Arterial Oxygen Saturation and Patient Tolerance During Esophagogastroduodenoscopy

Sedation for upper gastrointestinal endoscopy: a comparison of alfentanil-midazolam and meperidine-diazepam

Effect of Upper Gastrointestinal Endoscopy on Circulation in the Elderly

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