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Erschienen in:
24.11.2016 | Original Contributions
Safety Analysis of Bariatric Patients Undergoing Outpatient Upper Endoscopy with Non-Anesthesia Administered Propofol Sedation
Erschienen in: Obesity Surgery | Ausgabe 6/2017
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Background
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.
Methods
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.
Results
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.
Conclusions
With appropriate training of endoscopy personnel, NAAP is a safe method of sedation in severely obese patients undergoing outpatient upper endoscopy.