Prolonged upper gastrointestinal endoscopy with deep sedation led to decreased oxygen saturation (mean 82.9%), tachycardia in 16 of 20 patients, and S-T segment depression correlated with hypoxaemia.
Observational (n=20)
What are the cardiorespiratory changes during upper gastrointestinal endoscopy with deep sedation?
Prolonged upper GI endoscopy with deep sedation is associated with significant cardiorespiratory changes, including hypoxaemia, tachycardia, and arrhythmias, highlighting the need for careful monitoring.
Critical events including hypoxaemia, arrhythmias and myocardial ischaemia may occur more frequently during endoscopic procedures than during anaesthesia. A study was undertaken to assess the cardiovascular changes and to evaluate suitable monitoring techniques to detect critical events during sedation and endoscopy. Twenty patients scheduled to undergo a prolonged endoscopic procedure which required deep sedation were studied. Continuous recordings of electrocardiogram, heart rate and arterial oxygen saturation were made and arterial pressure was recorded at one-minute intervals. The study commenced immediately before administration of sedatives, continued for the duration of the examination and for one hour following the examination. Oxygen saturation decreased in all patients during the examination to a mean of 82.9% (SD 11.9), and remained below baseline for the duration of the examination and into the recovery period. Statistically significant increases and reductions of systolic arterial pressure and rate-pressure product were found during the procedures compared with baseline values recorded before administration of sedatives. Sixteen of the 20 patients developed tachycardia during the examination. Ten patients developed ectopic foci which were supraventricular, ventricular or both in origin. Electrocardiogram changes resolved during the recovery period. Myocardial ischaemia was assessed by S-T segment depression and a significant correlation was found between S-T segment depression and hypoxaemia, although the magnitude of the S-T depression was small and may not have been detected clinically. No correlation was found between S-T segment depression and arterial pressure, heart rate or rate-pressure product.(ABSTRACT TRUNCATED AT 250 WORDS)
Murray et al. (Fri,) conducted a observational in Patients scheduled for prolonged endoscopic procedure requiring deep sedation (n=20). Prolonged upper gastrointestinal endoscopy with deep sedation was evaluated on Mean oxygen saturation during examination. Prolonged upper gastrointestinal endoscopy with deep sedation led to decreased oxygen saturation (mean 82.9%), tachycardia in 16 of 20 patients, and S-T segment depression correlated with hypoxaemia.