Key result
ORi-guided pre-oxygenation fails to significantly reduce moderate desaturation vs standard monitoring during endoscopic sedation.
Why the study?
To assess whether ORi-guided pre-oxygenation and ORi monitoring added to capnography and pulse oximetry is more effective than standard monitoring alone in preventing cardio-respiratory events during endoscopic sedation.
Does ORi guided pre-oxygenation and monitoring reduce cardio-respiratory events in endoscopy patients undergoing sedation?
RCT (n=200)
Single-blind
Computer based system
No
Does ORi guided pre-oxygenation and monitoring reduce cardio-respiratory events in endoscopy patients undergoing sedation?
Absolute Event Rate: 7.6% vs 17%
p-value: p=0.06
ORi-guided pre-oxygenation and monitoring during endoscopic sedation significantly reduces low ORi events and may help prevent hypoxemia.
ORi guidance did not significantly reduce moderate desaturation; leaves open its role in preventing hypoxemia during endoscopic sedation.
Purpose: To assess whether ORi guided pre-oxygenation and ORi monitoring in addition to capnography and pulse oximetry is more effective than standard monitoring alone to prevent cardio-respiratory events in endoscopic sedation. Methods: This prospective, randomized, single blinded study included 200 endoscopy patients which randomized to two groups. All the participants had ORi, SpO2, ETCO2, non-invasive blood pressure and heart rhythm monitoring. In Group I anesthesiologist was blinded to ORi. Five min pre-oxygenation (5 L/min via nasal cannula) applied to all participant in sitting position, with ORi guidance to reach steady state in ORi. Propofol boluses were applied for sedation. Mild and moderate desaturation, and hypoventilation were recorded. Results: Seventeen per cent moderate desaturation (SpO2<90%) observed in Group I whereas rate was 7.6% in Group II (p:0.06). Hypoventilation rate was 23% and 12% in Group I and II respectively (p:0.057). Low ORI rate was statistically significantly higher in Group I (19%) compared to Group II (4.3%)(p:0.002). Conclusions: Our results showed that ORi has ability to diminish hypoxemic events and putting patients in a mild hyperoxemic state and endeavor to keep this state can be alternative and reliable method for endoscopic sedation.
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Yağar et al. (2023) conducted an RCT in Endoscopic sedation (n=200). ORi-guided pre-oxygenation and monitoring vs. Standard monitoring (blinded to ORi) was evaluated on Moderate desaturation (SpO2 < 90%) (p=0.06). ORi-guided pre-oxygenation and monitoring during endoscopic sedation resulted in a moderate desaturation rate of 7.6% compared to 17% with standard monitoring alone (p=0.06).
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