Patient draping contributing to a near disaster (desaturation during endoscopy in a 2‐year‐old)

Brock‐Utne, John G.; Moynihan, Robert J.

doi:10.1111/j.1460-9592.1992.tb00226.x

Cited by 10 publications

(3 citation statements)

References 2 publications

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“…This is observed more frequently by a large-diameter endoscope (10,11) and in small children (10). In small infants and children, gastric distension due to air insufflation may also lead to severe hypoxia (12). Medications used for sedation are potent central nervous system depressants and can lead to hypoventilation, particularly when several drugs are combined (13).…”

Section: Discussionmentioning

confidence: 99%

Flexible Upper Videoendoscopy Through a Modified Endoscopy Mask in Infants and Young Children

Somri

Gaitini

Yanovski

et al. 2009

J. pediatr. gastroenterol. nutr.

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Section: Discussionmentioning

confidence: 99%

Flexible Upper Videoendoscopy Through a Modified Endoscopy Mask in Infants and Young Children

Somri

Gaitini

Yanovski

et al. 2009

J. pediatr. gastroenterol. nutr.

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“…This is more frequent with the endoscope of larger diameter (11,12) and in small children(11). In small infants and children, gastric distension with air insufflation may also hinder the diaphragmatic course and may lead to severe hypoxia (20). Medications used for sedation are potent central nervous system depressants and can lead to hypoventilation, particularly when several drugs are combined(4).…”

Section: Discussionmentioning

confidence: 99%

Oxygen Saturation during Esophagogastroduodenoscopy in Children: General Anesthesia versus Intravenous Sedation

Lamireau,

Dubreuil,

Daconceicao

1998

J. pediatr. gastroenterol. nutr.

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Background:Hypoxia may occur in children undergoing upper digestive endoscopy under sedation. The purpose of this study was to compare the occurrence of desaturation during intravenous sedation with that which occurs during general anesthesia.Methods:Thirty‐six patients between 3 months and 6 years old underwent a diagnostic esophagogastroduodenoscopy under sedation (n = 18) or general anesthesia (n = 18). Oxygen pulse oximetry, heart rate, and mean arterial pressure were monitored throughout the procedure. At the end of the procedure, the operator gave the value of the endoscopy satisfaction score on a scale of I (very good conditions) to IV (impossible procedure).Results:The minimum oxygen pulse oximetry value was significantly lower in the sedation group compared with that in the general anesthesia group (89± 5 vs. 97 ± 1; p < 0.001). In the general anesthesia group, the oxygen pulse oximetry level declined to less than 95% in only one child; but in the sedation group, it declined to less than 95% in 16 patients (5.5% vs. 89%). Nine patients had a profound desaturation in sedation group (oxygen pulse oximetry <90%); no patients in the general anesthesia group had desaturation (50% vs. 0%). In the general anesthesia group, heart rate and mean arterial pressure remained stable during the whole procedure, whereas in the sedation group, heart rate and mean arterial pressure increased significantly during the procedure. The endoscopy satisfaction score was I in all 18 patients in the general anesthesia group, whereas in the sedation group, it was I in only 2 patients, II in 8 patients, and III in 10 patients.Conclusions:These results confirm that hypoxia during upper digestive endoscopy in patients under sedation is a frequent occurrence in children. When compared with sedation, general anesthesia is a safer technique that prevents hypoxia and allows the gastroenterologist to perform the endoscopy under better conditions.

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“…However, previous studies showed that atropine decreases lower oesophageal sphincter (LOS) pressure, an important antireflux mechanism, in both adults and symptomatic children (6,7). In theory, lowering the LOS pressure by atropine may not only increase the potential for regurgitation of gastric contents, but also aggravate gastric distension by anaesthetic gas, which may produce an extrathoracic competitor to ventilation (8). On the other hand, i.v.…”

Section: Introductionmentioning

confidence: 99%

Effects of i.v. metoclopramide, atropine and their combination on gastric insufflation in children anaesthetized with sevoflurane and nitrous oxide

Suga

Tanaka

Toyooka

2001

Pediatric Anesthesia

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Patient draping contributing to a near disaster (desaturation during endoscopy in a 2‐year‐old)

Cited by 10 publications

References 2 publications

Flexible Upper Videoendoscopy Through a Modified Endoscopy Mask in Infants and Young Children

Flexible Upper Videoendoscopy Through a Modified Endoscopy Mask in Infants and Young Children

Oxygen Saturation during Esophagogastroduodenoscopy in Children: General Anesthesia versus Intravenous Sedation

Effects of i.v. metoclopramide, atropine and their combination on gastric insufflation in children anaesthetized with sevoflurane and nitrous oxide

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