Sedation Guidelines for Gastro Intestinal Endoscopy

Murthy, Tvsp

doi:10.1016/s0377-1237(09)80133-0

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Sedation was commonly used during endoscopy procedures because it can improve patient acceptance and tolerance via relieving discomfort and facilitating sympathetic patient management [1] . Lines of evidence demonstrated that sedation using optimal sedation and analgesia by endoscopist with or without help of anesthesiologist is safe and cost-efficient [1] – [3] . But cardiopulmonary adverse events (CAEs) that are related to conscious sedation occurred frequently during the procedures [1] , [4] – [9] .…”

Section: Introductionmentioning

confidence: 99%

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Pre-Existing Diseases of Patients Increase Susceptibility to Hypoxemia during Gastrointestinal Endoscopy

Long

Liu

et al. 2012

PLoS ONE

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Hypoxemia is the most common adverse event that happened during gastrointestinal endoscopy. To estimate risk of hypoxemia prior to endoscopy, American Society of Anesthesiology (ASA) classification scores were used as a major predictive factor. But the accuracy of ASA scores for predicting hypoxemia incidence was doubted here, considering that the classification system ignores much information about general health status and fitness of patient that may contribute to hypoxemia. In this retrospective review of clinical data collected prospectively, the data on 4904 procedures were analyzed. The Pearson’s chi-square test or the Fisher exact test was employed to analyze variance of categorical factors. Continuous variables were statistically evaluated using t-tests or Analysis of variance (ANOVA). As a result, only 245 (5.0%) of the enrolled 4904 patients were found to present hypoxemia during endoscopy. Multivariable logistic regressions revealed that independent risk factors for hypoxemia include high BMI (BMI 30 versus 20, Odd ratio: 1.52, 95% CI: 1.13–2.05; P = 0.0098), hypertension (Odd ratio: 2.28, 95% CI: 1.44–3.60; P = 0.0004), diabetes (Odd ratio: 2.37, 95% CI: 1.30–4.34; P = 0.005), gastrointestinal diseases (Odd ratio: 1.77, 95% CI: 1.21–2.60; P = 0.0033), heart diseases (Odd ratio: 1.97, 95% CI: 1.06–3.68; P = 0.0325) and the procedures that combined esophagogastroduodenoscopy (EGD) and colonoscopy (Odd ratio: 4.84, 95% CI: 1.61–15.51; P = 0.0292; EGD as reference). It is noteworthy that ASA classification scores were not included as an independent predictive factor, and susceptibility of youth to hypoxemia during endoscopy was as high as old subjects. In conclusion, some certain pre-existing diseases of patients were newly identified as independent risk factors for hypoxemia during GI endoscopy. High ASA scores are a confounding predictive factor of pre-existing diseases. We thus recommend that youth (≤18 yrs), obese patients and those patients with hypertension, diabetes, heart diseases, or GI diseases should be monitored closely during sedation endoscopy.

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Section: Introductionmentioning

confidence: 99%

“…Lines of evidence demonstrated that sedation using optimal sedation and analgesia by endoscopist with or without help of anesthesiologist is safe and cost-efficient [1] – [3] . But cardiopulmonary adverse events (CAEs) that are related to conscious sedation occurred frequently during the procedures [1] , [4] – [9] .…”

Section: Introductionmentioning

confidence: 99%

Pre-Existing Diseases of Patients Increase Susceptibility to Hypoxemia during Gastrointestinal Endoscopy

Long

Liu

et al. 2012

PLoS ONE

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Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique

Abitağaoğlu

Turan

et al. 2018

Int Ophthalmol

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A Cross-Sectional Study to Compare Anesthesia Techniques Employed for the Conduct of Upper Gastrointestinal Endoscopic Procedures in a Gastroenterology Suite of a Tertiary Care Hospital

Sud¹,

Dwivedi²,

Dudeja³

et al. 2021

Journal of Medical Sciences

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Background: Endoscopic procedures in gastroenterology (GE) imaging suite are conducted primarily under moderate sedation (MS) and general anesthesia (GA). Various factors determine the choice of the technique such as the physical status of the patient, an anticipated difficult procedure, or an unanticipated complication. Aims: The aim was to study various factors affecting the selection of anesthesia techniques in patients undergoing endoscopy. This was a cross-sectional descriptive study in a tertiary care hospital. Methods: All patients who underwent upper gastrointestinal endoscopic procedures (n = 373) from January 2017 to December 2018 were included in the study. Patients were divided into groups on the basis of the anesthesia technique employed as MS – Group I (n = 343) and GA – Group II (n = 30). Data were collected for patient related and procedure related factors such as age, sex, physical status of the patient, complexity of the endoscopic procedures, anesthesia duration, drugs used, complications and recovery profile, which were analyzed for the two groups as per the entries made in the GE suite and central anesthesia registry. Statistical analysis was done using SPSS software Version 22.0 (IBM Corp., Armonk, NY, USA). Categorical variables were tested using Chi-square test and means were compared using t-test. Conclusions: MS was preferred in patients with lesser grades of physical status and in less complex GE procedures as compared to GA.

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Sedation Guidelines for Gastro Intestinal Endoscopy

Abstract: Effective sedation is usually a vital precursor to any successful endoscopic procedure. With advanced techniques and medications available today this component of the procedure can be dealt with safely and in an efficient manner. MJAFI 2009; 65 : 161-165

Cited by 3 publications

References 15 publications

Pre-Existing Diseases of Patients Increase Susceptibility to Hypoxemia during Gastrointestinal Endoscopy

Pre-Existing Diseases of Patients Increase Susceptibility to Hypoxemia during Gastrointestinal Endoscopy

Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique

A Cross-Sectional Study to Compare Anesthesia Techniques Employed for the Conduct of Upper Gastrointestinal Endoscopic Procedures in a Gastroenterology Suite of a Tertiary Care Hospital

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