More than half of hypoxemia cases occurred during the recovery period after completion of esophagogastroduodenoscopy with planned moderate sedation.
Adolescent
Adult
Aged
Aged, 80 and over
Conscious Sedation
/ adverse effects
Digestive System Diseases
/ pathology
Endoscopy, Digestive System
/ adverse effects
Female
Humans
Hypoxia
/ epidemiology
Incidence
Japan
/ epidemiology
Male
Middle Aged
Postoperative Complications
/ epidemiology
Postoperative Period
Retrospective Studies
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
09 03 2020
09 03 2020
Historique:
received:
19
07
2019
accepted:
22
02
2020
entrez:
11
3
2020
pubmed:
11
3
2020
medline:
25
11
2020
Statut:
epublish
Résumé
Guidelines advise precautionary measures for possible adverse events that may occur due to sedation during endoscopic procedures. To avoid complications, intraprocedural and postprocedural monitoring during recovery is considered important. However, since not many studies have reported on hypoxemia during the recovery period, findings for specific monitoring methods are insufficient. The aim of this retrospective study was to determine the incidence of hypoxemia during the recovery period using continuous central-monitoring by pulse oximetry and to characterize the hypoxemia cases. Among the 4065 consecutive esophagogastroduodenoscopy (EGD) procedures under planned moderate sedation, 84 (2.1%) procedures developed unexpected hypoxemia (SpO
Identifiants
pubmed: 32152344
doi: 10.1038/s41598-020-61120-0
pii: 10.1038/s41598-020-61120-0
pmc: PMC7063059
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4312Références
Waring, J. P. et al. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy. Gastrointest. Endosc. 58, 317–322 (2003).
doi: 10.1067/S0016-5107(03)00001-4
Riphaus, A. et al. S3 Guideline: Sedation for gastrointestinal endoscopy 2008. Endoscopy 41, 787–815 (2009).
doi: 10.1055/s-0029-1215035
Obara, K. et al. Guidelines for sedation in gastroenterological endoscopy. Dig. Endosc. 27, 435–449 (2015).
doi: 10.1111/den.12464
Gross, J. B. et al. Practice guidelines for sedation and analgesia by non-anesthesiologists: An updated report by the American Society of Anesthesiologists task force on sedation and analgesia by non-anesthesiologists. Anesthesiology 96, 1004–1017 (2002).
doi: 10.1097/00000542-200204000-00031
ASGE Ensuring Safety in the Gastrointestinal Endoscopy Unit Task Force. et al. Guidelines for safety in the gastrointestinal endoscopy unit. Gastrointest. Endosc. 79, 363–372 (2014).
doi: 10.1016/j.gie.2013.12.015
ASGE Standards of Practice Committee. et al. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest. Endosc. 87, 327–337 (2018).
doi: 10.1016/j.gie.2017.07.018
Furuta, T. et al. The sixth national survey on the adverse events of gastrointestinal endoscopy: Results of the Japan Gastroenterological Endoscopy Society survey from 2008 to 2012. Gastroenterol. Endosc. 58, 1466–1491 (2016).
Hennessy, M. J., Kirkby, K. C. & Montgomery, I. M. Comparison of the amnesic effects of midazolam and diazepam. Psychopharmacol. 103, 545–550 (1991).
doi: 10.1007/BF02244257
Bell, G. D., Morden, A., Coady, T., Lee, J. & Logan, R. F. A comparison of diazepam and midazolam as endoscopy premedication assessing changes in ventilation and oxygen saturation. Br. J. Clin. Pharmacol. 26, 595–600 (1988).
doi: 10.1111/j.1365-2125.1988.tb05300.x
Takrouri, M. S., Toukan, A., Badran, I., Sbeih, Z. & Hunjul, N. Diazepam, flunitrazepam and midazolam for elective endoscopy–a comparative study. Middle East. J. Anaesthesiol. 9, 529–536 (1988).
pubmed: 3062352
pmcid: 3062352
Bullimore, D. W., Mulley, B. A., Cooke, P. & Miloszewski, K. J. Comparison of the effectiveness of midazolam and diazepam in lipid emulsion as sedation during upper gastrointestinal endoscopy. Aliment. Pharmacol. Ther. 1, 409–414 (1987).
doi: 10.1111/j.1365-2036.1987.tb00641.x
Bardhan, K. D., Morris, P., Taylor, P. C., Hinchliffe, R. F. & Harris, P. A. Intravenous sedation for upper gastrointestinal endoscopy: diazepam versus midazolam. Br. Med. J. (Clin. Res. Ed.). 288, 1046 (1984).
doi: 10.1136/bmj.288.6423.1046
Stufe 1 Leitlinie Sedierung und Analgesie (Analgosedierung) von Patienten durch Nicht-Anästhesisten. http://www.dgai.de/06pdf/13_573-Leitlinie.pdf , http://intranet/awmf11/001-011.htm (2008).
Chutkan, R. et al. Training guideline for use of propofol in gastrointestinal endoscopy. Gastrointest. Endosc. 60, 167–172 (2004).
doi: 10.1016/S0016-5107(04)01699-2
Haines, D. J., Bibbey, D. & Green, J. R. The effects of flumazenil on alertness and hypoxia in elderly patients after ERCP. Aliment. Pharmacol. Ther. 6, 745–750 (1992).
doi: 10.1111/j.1365-2036.1992.tb00739.x
Cohen, L. B. et al. AGA Institute review of endoscopic sedation. Gastroenterology. 133, 675–701 (2007).
doi: 10.1053/j.gastro.2007.06.002
Enestvedt, B. K., Eisen, G. M., Holub, J. & Lieberman, D. A. Is ASA classification useful in risk stratification for endoscopic procedures? Gastrointest. Endosc. 77, 464–471 (2013).
doi: 10.1016/j.gie.2012.11.039
Leslie, K. et al. Safety of sedation for gastrointestinal endoscopy in a group of university-affiliated hospitals: a prospective cohort study. Br. J. Anaesth. 118, 90–99 (2017).
doi: 10.1093/bja/aew393
Takeuchi, M. et al. The Japanese Society of Anesthesiologists. Guidelines for the usage of anesthetic drugs and associated drugs; 3rd edition. http://www.anesth.or.jp/guide/pdf/publication4-1_20181004s.pdf, http://www.anesth.or.jp/guide/pdf/publication4-3_20181004s.pdf (2018).
Vargo, J. J. et al. Multisociety Sedation Curriculum for Gastrointestinal Endoscopy. Am J Gastroenterol. https://www.giejournal.org/article/S0016-5107(12)00227-1/fulltext (2012).