title: Adverse events during monitored anesthesia care for GI endoscopy: an 8-year experience.
abstract: BACKGROUND
  The importance of sedation during endoscopy is well established. There is no consensus about the best techniques for sedation, which specialist should perform it, and in which location.
  
  
  OBJECTIVE
  To provide data on the epidemiology of adverse events during sedation for endoscopy.
  
  
  METHODS
  Retrospective analysis of a prospective database.
  
  
  METHODS
  Endoscopy unit of a university hospital.
  
  
  METHODS
  A total of 17,999 procedures performed over 8 years.
  
  
  METHODS
  Sedation for GI endoscopy.
  
  
  METHODS
  We recorded the following information: sex, age, body mass index, smoking habits, American Society of Anesthesiologists and Mallampati scores, duration of the procedure, type of sedative drug administered, whether the procedure was performed emergently, and endoscopic interventions during the maneuver. Adverse events were defined as occurrences that warranted intervention and were classified as hypotension, desaturation, bradycardia, hypertension, arrhythmia, aspiration, respiratory depression, vomiting, cardiac arrest, respiratory arrest, angina, hypoglycemia, and/or allergic reaction.
  
  
  RESULTS
  Deep sedation with intravenous propofol target controlled infusion pump was the most frequently used means of administering sedation. Adverse events were rare in both the adult (4.5%) and pediatric (2.6%) populations. Six complications occurred in more than 0.1% of adult cases: arterial hypotension, desaturation, bradycardia, arterial hypertension, arrhythmia, and aspiration. Only bradycardia (2.1%) and hypotension (0.44%) occurred in children. Three adult patients (0.017%) died, and no pediatric patients died. Some predictive models for the occurrence of complications are proposed.
  
  
  CONCLUSIONS
  Retrospective analysis, single-center data collection.
  
  
  CONCLUSIONS
  Deep sedation during endoscopic procedures is safe in both adults and children. Our data may be useful for the future planning of new clinical strategies in this setting.
authors.affiliation: Department of Anesthesiology, Vita-Salute University of Milan, IRCCS H. San Raffaele, Milan, Italy. agostoni.massimo@hsr.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Agostoni
authors.forename: Lorella
authors.initials: L
authors.lastname: Fanti
authors.forename: Marco
authors.initials: M
authors.lastname: Gemma
authors.forename: Nicola
authors.initials: N
authors.lastname: Pasculli
authors.forename: Luigi
authors.initials: L
authors.lastname: Beretta
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D015992:Body Mass Index; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation / Q000009:adverse effects*; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D005283:Fentanyl; D006801:Humans; D006993:Hypnotics and Sedatives; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology; D000860:Hypoxia / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008738:Methyl Ethers; D008874:Midazolam; D008875:Middle Aged; D015742:Propofol; D012189:Retrospective Studies; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol