TY - JOUR
T1 - Sedation during endoscopy for patients at risk of obstructive sleep apnea
AU - Khiani, Vijay S.
AU - Salah, Wajeeh
AU - Maimone, Santo
AU - Cummings, Linda
AU - Chak, Amitabh
PY - 2009/12
Y1 - 2009/12
N2 - Background: Obstructive sleep apnea (OSA) has become increasingly prevalent in the United States and often goes undiagnosed. Objective: To assess the proportion of patients undergoing routine endoscopic procedures who are at risk of OSA and to determine whether these patients are at risk of sedation-related hypoxia. Design and Setting: Prospective case-control study at an academic medical center. Patients and Interventions: Patients undergoing routine EGD and colonoscopy were administered the Berlin Questionnaire, a brief validated survey that stratifies patients into high or low risk of OSA. Data on pulse oximetry and oxygen use were collected. Main Outcome Measurements: Rates of transient hypoxia, defined as a pulse oximetry measurement less than 92% requiring an increase in supplemental oxygen were compared between the high- and low-risk OSA groups. Results: Of the 261 prospectively recruited patients, 28 were excluded for violating study protocol. Ninety (39%) of the remaining 233 patients were scored as being at high risk of OSA. There was no significant difference in the rate of transient hypoxia between the high- and low-risk groups (odds ratio 1.48; 95% CI, 0.58-3.80). Limitations: Single-center study. OSA was not confirmed with a sleep study. Conclusion: Approximately one third of patients undergoing routine outpatient endoscopic procedures at a university hospital scored as being at high risk of OSA. There was no significant difference in the rates of transient hypoxia between high- and low-risk groups, suggesting that the majority of patients with no diagnosis of OSA can undergo conscious sedation for routine endoscopic procedures with standard monitoring practices.
AB - Background: Obstructive sleep apnea (OSA) has become increasingly prevalent in the United States and often goes undiagnosed. Objective: To assess the proportion of patients undergoing routine endoscopic procedures who are at risk of OSA and to determine whether these patients are at risk of sedation-related hypoxia. Design and Setting: Prospective case-control study at an academic medical center. Patients and Interventions: Patients undergoing routine EGD and colonoscopy were administered the Berlin Questionnaire, a brief validated survey that stratifies patients into high or low risk of OSA. Data on pulse oximetry and oxygen use were collected. Main Outcome Measurements: Rates of transient hypoxia, defined as a pulse oximetry measurement less than 92% requiring an increase in supplemental oxygen were compared between the high- and low-risk OSA groups. Results: Of the 261 prospectively recruited patients, 28 were excluded for violating study protocol. Ninety (39%) of the remaining 233 patients were scored as being at high risk of OSA. There was no significant difference in the rate of transient hypoxia between the high- and low-risk groups (odds ratio 1.48; 95% CI, 0.58-3.80). Limitations: Single-center study. OSA was not confirmed with a sleep study. Conclusion: Approximately one third of patients undergoing routine outpatient endoscopic procedures at a university hospital scored as being at high risk of OSA. There was no significant difference in the rates of transient hypoxia between high- and low-risk groups, suggesting that the majority of patients with no diagnosis of OSA can undergo conscious sedation for routine endoscopic procedures with standard monitoring practices.
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U2 - 10.1016/j.gie.2009.05.036
DO - 10.1016/j.gie.2009.05.036
M3 - Article
C2 - 19660748
AN - SCOPUS:71049160845
VL - 70
SP - 1116
EP - 1120
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 6
ER -