Respiratory complications during recovery from gastrointestinal endoscopies performed by gastroenterologists under moderate sedation

Clin Endosc. 2023 Mar;56(2):188-193. doi: 10.5946/ce.2022.033. Epub 2023 Jan 10.

Abstract

Background/aims: Data on the incidence of adverse respiratory events during recovery from gastrointestinal endoscopy are limited. The aim of this study was to investigate the incidence of these complications.

Methods: In this retrospective cohort study, data were obtained from the electronic records of 657 consecutive patients, who underwent gastroenterological procedures under sedation.

Results: Pulse oximetry oxygen saturation (SpO2) <90% for <60 seconds occurred in 82 patients (12.5%) and in 11 patients (1.7%), SpO2 of <90% for >60 seconds occurred in 79 patients (12.0%) and in 11 patients (1.7%), and SpO2 <75% occurred in four patients (0.6%) and in no patients during the procedure and recovery period, respectively. No major complications were noted. The occurrence of desaturation during recovery was correlated with desaturation during the procedure (p<0.001). American Society of Anesthesiologists score (odds ratio [OR], 1.867; 95% confidence interval [CI], 1.008-3.458), ischemic heart disease (OR, 1.815; 95% CI, 0.649-5.080), hypertension (OR, 1.289; 95% CI, 0.472-3.516), and diabetes mellitus (OR, 2.406; 95% CI, 0.950-6.095) increased the occurrence of desaturation during recovery.

Conclusion: We found no major complications during recovery after balanced propofol-based sedation administered by a gastroenterologist-nurse team. Patients with the identified risk predictors must be monitored carefully.

Keywords: Conscious sedation; Gastroenterologists; Gastrointestinal endoscopy; Hypoxia; Recovery room.