Tu1068 ENDOSCOPIC CLOSURE OF ACUTE PERFORATIONS OF THE GASTROINTESTINAL TRACTS IN ANIMAL MODELS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

acting opioids with benzodiazepines, long-acting opioids with benzodiazepines, and short-acting opioids with propofol. The primary outcome was the frequency of cardiorespiratory events, defined as intra-procedural episodes of hypotension or hypoxemia. We conducted a random-effects Bayesian network meta-analysis using Markov Chain Monte Carlo simulation methods to generate risk ratios and 95% credible intervals for each sedative comparison. We plotted cumulative ranking probabilities based on the direct and indirect estimates generated by the network. Results: We identified 20 studies, including 2,277 patients, directly comparing the cardiorespiratory events between sedatives of interest. Cardiorespiratory events were rare across all sedatives and sedative combinations. Long-acting opioids used with benzodiazepines were associated with a greater risk of cardiorespiratory events than short-acting opioids used alone (RR 3.73; 95% CrI: 1.14-15.15). We did not find any other significant differences in the risk of cardiorespiratory events between the various sedative combinations evaluated; however, there was a trend towards greater events when long-acting opioids with benzodiazepines were compared to all other sedative combinations and fewer events when short-acting opioids were compared to all sedative combinations (Table ). Ranking probabilities demonstrated short-acting opioids used alone to have the highest probability of being the safest sedative and long-acting opioids used with benzodiazepines to have the highest probability of being the least safe sedative combination. Conclusions: The frequency of adverse cardiorespiratory events among the sedatives commonly used in colonoscopy is low. Propofol and non-propofol sedative combinations demonstrate similar cardiorespiratory risk profiles, suggesting equivalent safety when used in this setting.