Gill Jeffrey, Vidyarthi Gitanjali, Kulkarni Prasad, Anderson William, Boyd William
Division of Digestive Diseases, University of South Florida, Tampa, FL 33612, USA.
South Med J. 2011 Mar;104(3):185-8. doi: 10.1097/SMJ.0b013e318205e55e.
Due to the presumed higher risk of cardiopulmonary complications in patients with obstructive sleep apnea (OSA), many endoscopy centers consider OSA a contraindication to using conscious sedation. We evaluated the safety of conscious sedation during endoscopy for patients with OSA in a veteran population, and compared this to patients without OSA.
Polysomnography studies were reviewed from 2004 to 2009 to identify 200 patients with OSA who had undergone endoscopy. Controls included the last 200 consecutive endoscopies in this institution for patients without OSA. Sixty-three upper endoscopies, 136 colonoscopies, and one enteroscopy were included in the OSA group. Sixty-five upper endoscopies, 133 colonoscopies, one sigmoidoscopy, and one endoscopic ultrasound comprised the control group. Data obtained included demographics, medications prescribed, and any complication noted in the procedure report.
No complications occurred in the control group. In the OSA group, a patient experienced oxygen desaturation during an upper endoscopy and required oxygen supplementation. The procedure was completed and did not require an extended stay in the endoscopy suite.
This study demonstrated that endoscopy can be safely done in OSA patients using conscious sedation, and the complication rate is not significantly different than patients without OSA.
由于阻塞性睡眠呼吸暂停（OSA）患者被认为发生心肺并发症的风险较高，许多内镜检查中心将OSA视为使用清醒镇静的禁忌症。我们评估了退伍军人中OSA患者在内镜检查期间清醒镇静的安全性，并将其与无OSA的患者进行比较。
回顾了2004年至2009年的多导睡眠图研究，以确定200例接受过内镜检查的OSA患者。对照组包括该机构最近连续200例无OSA患者的内镜检查。OSA组包括63例上消化道内镜检查、136例结肠镜检查和1例小肠镜检查。对照组包括65例上消化道内镜检查、133例结肠镜检查、1例乙状结肠镜检查和1例内镜超声检查。获得的数据包括人口统计学资料、开具的药物以及手术报告中记录的任何并发症。
对照组未发生并发症。在OSA组中，1例患者在上消化道内镜检查期间出现氧饱和度下降，需要吸氧。手术完成，无需在内镜检查室延长停留时间。
本研究表明，OSA患者使用清醒镇静可安全地进行内镜检查，其并发症发生率与无OSA的患者无显著差异。
