A prediction model for hypoxemia during routine sedation for gastrointestinal endoscopy

Geng, Wujun; Jia, Danyu; Wang, Yichuan; Jin, Shenhui; Ren, Yelong; Liang, Dongdong; Zheng, Aote; Tang, Hongli; Basharat, Zarrin; Zimmer, Vincent; Stock, Simon; Zippi, Maddalena; Wang, Hong

doi:10.6061/clinics/2018/e513

Cited by 26 publications

(32 citation statements)

References 23 publications

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“…This prospective observational study was conducted between 5 July, 2017, and 31 July, 2017, in the First Affiliated Hospital of Wenzhou Medical University. 4 Patients with American Society of Anesthesiologists (ASA) status I-III undergoing routine gastroscopy and/or colonoscopy examination were enrolled. Exclusion criteria were therapeutic endoscopy, prior gastric or colonic resection, inadequate bowel preparation, severe cardiopulmonary diseases before data collection, patients with ASA class of 4 or higher and lack of complete data availability.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

et al. 2019

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Objective This study was designed to assess clinical predictors of hypoxemia and develop an artificial neural network (ANN) model for prediction of hypoxemia during sedation for gastrointestinal endoscopy examination. Methods A total of 220 patients were enrolled in this prospective observational study. Data on demographics, chronic concomitant disease information, neck circumference, thyromental distance and anaesthetic dose were collected and statistically analysed. Results Univariate analysis indicated that body mass index (BMI), habitual snoring and neck circumference were associated with hypoxemia. An ANN model was developed with three variables (BMI, habitual snoring and neck circumference). The area under the receiver operating characteristic curve for the ANN model was 0.80. Conclusions The ANN model developed here, comprising BMI, habitual snoring and neck circumference, was useful for prediction of hypoxemia during sedation for gastrointestinal endoscopy.

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Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

et al. 2019

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“…Propofol has become the first choose sedative drug for colonoscopy [ 2 ] because of its rapid action, strong sedation, short half-life, rapid recovery, and higher satisfaction [ 3 ]. However, it was reported that respiratory depression and cardiovascular events were common sedation-related complications during propofol-based sedation [ 4 , 5 ], especially in elderly patients [ 6 ]. Moreover, age-related pharmacokinetic changes and patient comorbidities are of great concern during the sedation process.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Zhuang

2022

BMC Anesthesiol

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Background Elderly patients undergoing colonoscopy with propofol as sedation are prone to respiratory or cardiovascular complications. Intravenous lidocaine has analgesic efficacy and reduces propofol consumption during surgery. Here, the effect of intravenous lidocaine on propofol consumption was evaluated in elderly patients undergoing colonoscopy. Methods Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose, followed by a 2 mg/kg/h continuous infusion during the procedure; Group L) or a placebo (saline; Group N). During the procedure, sedation was achieved by propofol. The following outcomes were recorded: total propofol consumption; time to loss of consciousness; number of airway modifications; time to the first airway intervention; incidence of sedation-related events; pain score after awakening; endoscopists’ and patients’ satisfaction scores; memory level of the procedure; and adverse events within 24 h postoperatively. Results Compared with Group N, propofol consumption was reduced by 13.2% in Group L (100.30 ± 25.29 mg vs. 115.58 ± 27.52 mg, respectively, p = 0.008). Kaplan–Meier curves showed that the median time to the loss of consciousness episode was shorter in Group L than in Group N (40 s vs. 55 s, respectively, log rank p < 0.0001). The number of airway modifications, time to the first airway intervention, incidence of sedation-related events, time to awakening, pain score after awakening, endoscopists’ and patients’ satisfaction scores, memory level of the procedure and adverse events within 24 h postoperatively did not differ between the two groups (p > 0.05). Conclusions Intravenous lidocaine can reduce propofol consumption in elderly patients undergoing colonoscopy, with quicker time to loss of consciousness. Trial registration The clinical trial was registered at (12/01/2021, ChiCTR2100042001).

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“…There is some consensus in literature on the risk factors for adverse events related to deep sedation with propofol. Geng et al reported that age, BMI, total propofol dose, smoking, and alcohol consumption are adverse risk factors associated with gastrointestinal endoscopy hypoxemia ( 21 ). Another study suggested that age, larger propofol doses, and smoking are associated with a higher incidence of sedation-related adverse events during colonoscopy ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients

Fang

Cao

et al. 2022

Front. Med.

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BackgroundRespiratory depression is a life-threatening adverse effect of deep sedation. This study aimed to investigate the factors related to hypoxia caused by propofol during intravenous anesthesia.MethodsThree hundred and eight patients who underwent painless artificial abortion in the outpatient department of Shanghai Tenth People’s Hospital between November 1, 2019 and June 30, 2020 were divided into two groups according to whether the patients experienced hypoxia (SpO2 < 95%). Preoperative anxiety assessments, anesthesia process, and operation-related information of the two groups were analyzed. The univariate analysis results were further incorporated into logistic regression analysis for multivariate analysis to determine the independent risk factors affecting hypoxia.ResultsUnivariate analysis revealed that body mass index (BMI) (21.80 ± 2.94 vs. 21.01 ± 2.39; P = 0.038, 95% confidence interval (CI) = [−1.54, −0.04]), propofol dose (15.83 ± 3.21 vs. 14.39 ± 3.01; P = 0.002, CI = [−2.34, −0.53]), menopausal days (49.64 ± 6.03 vs. 52.14 ± 5.73; P = 0.004, CI = [0.79, 4.21]), State Anxiety Inventory score (51.19 ± 7.55 vs. 44.49 ± 8.96; P < 0.001, CI = [−9.26, −4.15]), and Self-rating Anxiety Scale score (45.86 ± 9.48 vs. 42.45 ± 9.88; P = 0.021, CI = [−6.30, −0.53]) were statistically significant risk factors for hypoxia during the operation. Logistic regression analysis showed that propofol dosage, menopausal days, and State Anxiety Inventory score were independent risk factors for hypoxia.ConclusionPatient anxiety affects the incidence of hypoxia when undergoing deep intravenous anesthesia with propofol. We can further speculate that alleviating patient anxiety can reduce the incidence of hypoxia.Clinical Trial Registration[http://www.chictr.org.cn], identifier [ChiCTR2000032167].

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A prediction model for hypoxemia during routine sedation for gastrointestinal endoscopy

Cited by 26 publications

References 23 publications

An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients

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