title: Safety Analysis of Bariatric Patients Undergoing Outpatient Upper Endoscopy with Non-Anesthesia Administered Propofol Sedation.
abstract: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported.
  
  
  
  In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m2) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database. Patients' demographics and procedural and recovery data, including any airway interventions, were statistically analyzed.
  
  
  
  We included 130 consecutive pre-operative bariatric surgical patients with average BMI 45.8 kg/m2(range 34-80) and 265 control patients with average BMI 21.9 kg/m2(range 14-25). The severely obese group had a higher prevalence of sleep apnea (62 vs 8%; p < 0.001), experienced more oxygen desaturations (22 vs 7%; p < 0.001), and received more chin lift maneuvers (20 vs 6%; p < 0.001). Advanced airway interventions were rarely required in either group and were not more frequent in the bariatric group.
  
  
  
  With appropriate training of endoscopy personnel, NAAP is a safe method of sedation in severely obese patients undergoing outpatient upper endoscopy.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 N 1900 E SOM 4R118, Salt Lake City, UT, 84132, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: McVay
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 N 1900 E SOM 4R118, Salt Lake City, UT, 84132, USA. John.Fang@hsc.utah.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Fang
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 N 1900 E SOM 4R118, Salt Lake City, UT, 84132, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Taylor
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 N 1900 E SOM 4R118, Salt Lake City, UT, 84132, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Au
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 N 1900 E SOM 4R118, Salt Lake City, UT, 84132, USA.
authors.forename: Wesley
authors.initials: W
authors.lastname: Williams
authors.affiliation: Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Angela P
authors.initials: AP
authors.lastname: Presson
authors.affiliation: Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Ragheed
authors.initials: R
authors.lastname: Al-Dulaimi
authors.affiliation: Division of General Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Volckmann
authors.affiliation: Division of General Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Ibele
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D015331:Cohort Studies; D016292:Procedural Sedation; D005260:Female; D005773:Gastroscopy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061214:Patient Safety; D011183:Postoperative Complications; D015995:Prevalence; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D014589:Utah
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol
keywords: Bariatrics; Endoscopy; Obesity; Propofol; Safety; Sedation