1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.
2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
Ann Am Thorac Soc. 2016 Mar;13(3):419-24. doi: 10.1513/AnnalsATS.201510-664OC.
The use of sedation allows medical procedures to be performed outside the operating room while ensuring patient comfort and a controlled environment to increase the yield of the procedure. There is concern about a higher risk of adverse events with use of sedation in patients with obstructive sleep apnea.
We aimed to determine if the presence of obstructive sleep apnea increased the risk of hospitalization and/or health care use after patients received moderate conscious sedation for an elective, ambulatory colonoscopy.
We conducted a retrospective case-control database and chart review study. We compared hospital admissions, intensive care unit (ICU) admissions, and emergency room visits at 24 hours, 7 days, and 30 days in patients with obstructive sleep apnea (n = 3,860) and without obstructive sleep apnea (n = 2,374) who had undergone an elective, ambulatory colonoscopy with sedation.
We found no significant differences in hospital admissions, ICU admissions, or emergency room visits between the two groups at any time point within the 30 days following the procedures. In a sensitivity analysis in which we compared 827 individuals with polysomnographically confirmed sleep apnea with control subjects, there was still no difference in hospital admissions, ICU admissions, or emergency room visits in the 30 days after receiving sedation for the procedure. Outcomes were not different in individuals with various severities of obstructive sleep apnea.
The presence of obstructive sleep apnea was not associated with increased early hospital admissions, ICU admissions, or emergency room visits after colonoscopy with sedation.
镇静的使用可以使医疗程序在手术室之外进行，同时确保患者的舒适度和受控环境，以提高程序的效果。在患有阻塞性睡眠呼吸暂停的患者中，使用镇静剂存在不良事件风险较高的担忧。
我们旨在确定在接受中度清醒镇静的患者进行选择性门诊结肠镜检查后，阻塞性睡眠呼吸暂停的存在是否会增加住院和/或医疗保健使用的风险。
我们进行了回顾性病例对照数据库和图表审查研究。我们比较了阻塞性睡眠呼吸暂停（n=3860）和无阻塞性睡眠呼吸暂停（n=2374）患者在接受选择性门诊结肠镜检查和镇静后的 24 小时、7 天和 30 天的住院、重症监护病房（ICU）入院和急诊就诊情况。
我们发现，在程序后的 30 天内，两组在任何时间点的住院、ICU 入院或急诊就诊均无显著差异。在一项比较 827 名经多导睡眠图证实患有睡眠呼吸暂停的个体和对照组的敏感性分析中，在接受镇静治疗后的 30 天内，住院、ICU 入院或急诊就诊也没有差异。在阻塞性睡眠呼吸暂停程度不同的个体中，结局也没有差异。
在接受镇静的结肠镜检查后，阻塞性睡眠呼吸暂停的存在与早期住院、ICU 入院或急诊就诊的增加无关。
