The role of sedation and pulse oximetry during upper gastrointestinal endoscopy.
BACKGROUND
To determine the changes in oxygen saturation, blood pressure and pulse rate during endoscopic procedure and to evaluate--oesophagogastroduodenoscopy (OGD) related discomfort assessed by the patient.


METHODS
It is observational case control study. Baseline pulse, blood pressure and oxygen saturation were monitored before procedure, at one minute of procedure, at five minute and soon after procedure. Patients were randomly selected according to lottery system (1: without sedation and 2: with sedation) and divided into two groups; without and with sedation. Before leaving department they were asked about level of discomfort during and after procedure.


RESULTS
Patient's mean age +/- SD: 36.65, +/- 11.42 years and 53.3% were men. Base line mean oxygen saturation among sedated patient were 96.77 +/-1.56 % and 97.23, +/- 2.26 % respectively (P = 0.358). Mild to moderate hypoxia was noted more in sedated patient than in non sedated patient. Severe hypoxia was noted in 3.3% of sedated patient. No statistically significant change was noticed in pulse and blood pressure in both the group. None or only slight discomfort was experienced by 9.4% in non sedated group and 90.6% in sedated group. Severe discomfort by 96.4% in non sedated group and 3.6% in sedated group.


CONCLUSIONS
There is slight more incidence of mild hypoxia in sedated group than in non sedated group but no change in pulse and blood pressure. However, sedated patient have significant less level of discomfort than in non sedated group. Though routine use of pulse oxymeter is not necessary, routine use of sedation during endoscopy is recommended.
Sharma
S K
SK
Department of Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal. samknp@yahoo.com
Maharjan
D K
DK
Thapa
P B
PB
Adhikari
S B
SB
Byenjankar
B
B
Khadka
S
S
Gurung
R
R
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016292:Procedural Sedation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D006801:Humans; D000860:Hypoxia / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry / Q000379:methods*; D010101:Oxygen Consumption / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies