Effects of Sedation and Supplemental Oxygen during Upper Alimentary Tract Endoscopy

Abstract

The effects of supplemental oxygen therapy on arterial oxygen saturation (SaO2) in unsedated and sedated patients have been studied using pulse oximetry. Hypoxia (minimum SaO2 92% or less) occurred in 41% of unsedated patients breathing room air but in only 11% (p < 0.01) of those receiving supplemental oxygen (41/min) by nasal cannulae. Comparable effects were seen in sedated patients (60% versus 16%, respectively, p < 0.01). Hypoxia during upper alimentary tract endoscopy is common with or without sedation and can be reduced by supplemental oxygen.

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

“…Although there are no randomised controlled trials comparing air vs. oxygen during ATI, data from bronchoscopy studies demonstrate that there is a significant difference in the incidence and severity of desaturation . In patients receiving sedation in a variety of settings, administration of oxygen has been shown to reduce the incidence of desaturation when compared with air . United Kingdom, European and North American recommendations for sedation all suggest the use of supplemental oxygen .…”

Practical considerations for colorectal cancer screening in older adults

“…During the procedure, standard monitoring procedures should be followed during procedures in the geriatric population. Maintaining a low threshold for beginning supplemental oxygen therapy is important as older patients are at higher risk of oxygen desaturation[ 82 ]. Another serious adverse event is delirium.…”

Double blind randomised controlled trial of effect of metoprolol on myocardial ischaemia during endoscopic cholangiopancreatography

“…Supplementary oxygen may increase arterial oxygen saturation during endoscopy4 5 6 7 8 9 but does not decrease the incidence of myocardial ischaemia 4 10 11. Previous studies have suggested tachycardia to be an important pathogenic factor in the development of myocardial ischaemia during endoscopy 1 4.…”