Airway complications during gastrointestinal endoscopy using propofol in a rural hospital | [Anaesthesia, Pain and Intensive Care • 2020]

Author(s):

1. Kelsey S. Flores: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

2. Jungbin A. Choi BA: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

3. Kathleen N. Johnson BS: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

4. David P. Vaneenenaam Jr.: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

5. Hannah M. Harris, BS: East Carolina University Brody School of Medicine, Greenville, North Carolina, USA

6. Daniel J. Forest,MD: Department of Anesthesiology, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, USA.

7. Yvon F. Bryan, MD: Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA

Abstract:

Background: Simple endoscopies such as esophagogastroduodenoscopy (EGD) and colonoscopies are common procedures that require the use of sedation or general anesthesia. The risk of airway complications for these procedures depends on the type of medications administered. Wide variation exists in reported rates of airway complications for endoscopic procedures. This retrospective study analyzed airway interventions and desaturations during simple endoscopy procedures performed by anesthesia-based teams (ABT) using propofol in a rural hospital. Methodology: An IRB approved retrospective study was conducted at Wake Forest Baptist Lexington Medical Center (LMC). Patients over age 18 who underwent an EGD, colonoscopy, or both from July to December 2017 were included. Demographics, comorbidities, airway interventions, incidence of desaturation, the mean doses of propofol, and duration of procedures were recorded. Results: Five hundred and thirteen patients underwent simple endoscopies (130 EGD, 320 colonoscopies, and 63 EGD/colonoscopy) at LMC. No patients required rescue intubation. One (0.2%) patient required BMV, three (0.6%) required a nasal airway, and three (0.6%) required an oral airway. 44 patients desaturated; 11 (25%) were severe and 33 (75%) moderate. Conclusion: We found that simple endoscopies performed by ABT had a low rate of airway interventions; however, the incidence of desaturation was higher than reported by other non-anesthesia-based teams and/or when clinicians used propofol for the endoscopies.

Page(s): 420-425

DOI: 10.35975/apic.v24i4.1314

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 24, Issue: 4, Year: 2020

Keywords:

Anesthesia , Propofol , endoscopic procedures , gastrointestinal endoscopy , rural health , desaturations

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