title: Sedation Challenges: Obesity and Sleep Apnea.
abstract: This article reviews the data for diagnostic and uncomplicated therapeutic upper endoscopy, which show it is safe and effective to perform the procedure under moderate sedation with a combination of benzodiazepine and opioids. For more complex procedures or for superobese patients anesthesia support is recommended. Performing endoscopy in this population should alert providers to plan carefully and individualize sedation plans because there is no objective way to quantify this risk pre-endoscopically.
authors.affiliation: Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
authors.forename: Pichamol
authors.initials: P
authors.lastname: Jirapinyo
authors.affiliation: Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: ccthompson@partners.org.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Thompson
mesh_terms: D050110:Bariatric Surgery; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods*; D054810:Deep Sedation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D016343:Monitoring, Intraoperative; D009765:Obesity; D020181:Sleep Apnea, Obstructive
keywords: Anesthesia; Bariatric endoscopy; Colonoscopy; Endoscopy; Gastric bypass; Obesity; Sedation