title: Hemodynamic changes during otolaryngological office-based flexible endoscopic procedures.
abstract: OBJECTIVE
  A preponderance of literature supports the safety of office-based flexible endoscopic procedures of the upper aerodigestive tract; however, until recently there were no data regarding hemodynamic stability during these procedures. A recent study showed intraprocedure changes in patients' hemodynamic parameters, raising the concern that perhaps patients should be monitored during these procedures. The aim of our study was to determine whether physiologically significant alterations in vital signs occur during office-based flexible endoscopic procedures.
  
  
  METHODS
  We performed a retrospective review of 100 consecutive patients who underwent office-based flexible endoscopic procedures of the upper aerodigestive tract from July 2010 to October 2011. Baseline values and the maximal changes in systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were recorded and compared.
  
  
  RESULTS
  One hundred consecutive patients were included in the study. Twenty-one patients (21%) had severe hypertension and 40 patients (40%) had tachycardia during the procedure. The mean change overall in systolic blood pressure was 26.2 mm Hg (p < 0.001), the mean change in diastolic blood pressure was 13.9 mm Hg (p < 0.001), the mean change in heart rate was 16.6 beats per minute (p < 0.001), and the mean change in oxygen saturation was 1.6% (p < 0.001). These changes were significant. On further breakdown into groups, patients over 50 years of age and patients who were undergoing esophageal or laser procedures had significant elevations in heart rate (p = 0.01 and p = 0.04, respectively). An elevation in diastolic blood pressure was also significant in patients who were undergoing esophageal or laser procedures (p = 0.04 for both).
  
  
  CONCLUSIONS
  These data concur with those of the previous report that found potentially significant hemodynamic changes during office-based procedures. Although preliminary, our findings suggest that it may be wise to monitor vital signs in patients over 50 years of age and patients who are undergoing an esophageal or laser procedure who are at risk for complications that could arise from tachycardia and hypertension.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Voice, Airway, and Swallowing Center, Georgia Health Sciences University, Augusta, Georgia, USA.
authors.forename: Michele P
authors.initials: MP
authors.lastname: Morrison
authors.forename: Ashli
authors.initials: A
authors.lastname: O'Rourke
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Dion
authors.forename: Robert L
authors.initials: RL
authors.lastname: Eller
authors.forename: Paul
authors.initials: P
authors.lastname: Weinberger
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Postma
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D001784:Blood Gas Analysis; D004724:Endoscopy / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D020380:Needs Assessment; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D055986:Vital Signs / Q000502:physiology*; D055815:Young Adult