Brief Article
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World J Gastroenterol. Aug 7, 2013; 19(29): 4745-4751
Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4745
Risk of sedation for diagnostic esophagogastroduodenoscopy in obstructive sleep apnea patients
Jae Myung Cha, Jung Won Jeun, Kwan Mi Pack, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Won-Chul Shin
Jae Myung Cha, Jung Won Jeun, Kwan Mi Pack, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Seoul 134-727, South Korea
Won-Chul Shin, Department of Neurology, Kyung Hee University Hospital at Gang Dong, Seoul 134-727, South Korea
Author contributions: Cha JM contributed to conception and design, analysis and interpretation of data; Jeun JW, Pack KM, Lee JI, Joo KR, Shin HP and Shin WC contributed to acquisition of data; all authors drafted the article or revised it critically for important intellectual content and made the final approval of the version to be published.
Correspondence to: Jae Myung Cha, MD, PhD, Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, South Korea. drcha@khu.ac.kr
Telephone: +82-2-4406110 Fax: +82-2-4406295
Received: April 26, 2013
Revised: June 10, 2013
Accepted: June 18, 2013
Published online: August 7, 2013
Abstract

AIM: To investigate whether patients with obstructive sleep apnea (OSA) are at risk of sedation-related complications during diagnostic esophagogastroduodenoscopy (EGD).

METHODS: A prospective study was performed in consecutive patients with OSA, who were confirmed with full-night polysomnography between July 2010 and April 2011. The occurrence of cardiopulmonary complications related to sedation during diagnostic EGD was compared between OSA and control groups.

RESULTS: During the study period, 31 patients with OSA and 65 controls were enrolled. Compared with the control group, a higher dosage of midazolam was administered (P = 0.000) and a higher proportion of deep sedation was performed (P = 0.024) in the OSA group. However, all adverse events, including sedation failure, paradoxical responses, snoring or apnea, hypoxia, hypotension, oxygen or flumazenil administration, and other adverse events were not different between the two groups (all P > 0.1). Patients with OSA were not predisposed to hypoxia with multivariate logistic regression analysis (P = 0.068).

CONCLUSION: In patients with OSA, this limited sized study did not disclose an increased risk of cardiopulmonary complications during diagnostic EGD under sedation.

Keywords: Conscious sedation, Obstructive sleep apnea, Endoscopy, Complications, Safety

Core tip: Patients with obstructive sleep apnea (OSA) are known to be vulnerable to cardiopulmonary complications during deep sedation and anesthesia; however, little is known about the risk of conscious sedation during esophagogastroduodenoscopy (EGD). This prospective study evaluated the cardiopulmonary complications related to conscious sedation during diagnostic EGD between OSA group (n = 31) and control group (n = 65). All adverse events, including sedation failure, paradoxical responses, snoring or apnea, hypoxia, hypotension, oxygen or flumazenil administration, and other adverse events were not different between groups. Therefore, the risk of cardiopulmonary complications during diagnostic EGD under sedation may not be increased in patients with OSA.