Garg Shashank, Syed Shorabuddin, Perisetti Abhilash, Inamdar Sumant, Vargo John
Division of Gastroenterology and Hepatology, Department of Medicine, UAMS, Little Rock, Arkansas, United States.
Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States.
Endosc Int Open. 2021 Nov 12;9(11):E1674-E1679. doi: 10.1055/a-1555-2762. eCollection 2021 Nov.
Endoscopic procedures are performed commonly with moderate sedation. Obesity can pose a challenge in its safe administration. This study was aimed at assessing outcomes of endoscopy procedures performed with moderate sedation in obese patients. This was a retrospective study of patients undergoing esophagogastroduodenoscopy (EGD) and/or colonoscopy with moderate sedation from July 17, 2017 to December 31, 2019. Demographics, comorbidities, outpatient medications and procedure-related outcomes (procedure time, recovery time, cardiopulmonary adverse events, 7-day post-procedure hospitalization, cecal intubation time, withdrawal time, tolerance of moderate sedation and sedation medications administered) were compared for patient with and without obesity after propensity score matching. Standard statistical methods were used for analysis. A total of 7601 procedures were performed with moderate sedation for 5746 patients. Propensity score matching identified 1360 and 1740 pairs of EGDs and colonoscopies with moderate sedation for patients with and without obesity. Recovery time was found to be shorter for obese patients undergoing EGD (OR: 0.989, 95 % CI: 0.981-.998; = 0.01). Obese patients did not differ from non-obese patients in any other procedure-related outcomes for EGDs or colonoscopies. Outcomes for endoscopy procedures performed with moderate sedation were noted to be similar between obese and non-obese patients. These findings suggest that moderate sedation can be used safely for endoscopic procedures in patients with obesity.
内镜检查通常在适度镇静下进行。肥胖可能给其安全实施带来挑战。本研究旨在评估肥胖患者在适度镇静下进行内镜检查的结果。 这是一项对2017年7月17日至2019年12月31日期间接受食管胃十二指肠镜检查(EGD)和/或结肠镜检查并采用适度镇静的患者的回顾性研究。在倾向评分匹配后,比较了肥胖患者和非肥胖患者的人口统计学、合并症、门诊用药以及与手术相关的结果(手术时间、恢复时间、心肺不良事件、术后7天住院情况、盲肠插管时间、退镜时间、对适度镇静的耐受性以及使用的镇静药物)。采用标准统计方法进行分析。 共对5746例患者进行了7601例适度镇静下的手术。倾向评分匹配确定了1360对和1740对分别用于肥胖患者和非肥胖患者的适度镇静下的EGD和结肠镜检查。发现接受EGD的肥胖患者恢复时间较短(OR:0.989,95%CI:0.981 - 0.998; = 0.01)。肥胖患者在EGD或结肠镜检查的任何其他与手术相关的结果方面与非肥胖患者没有差异。 肥胖患者和非肥胖患者在适度镇静下进行内镜检查的结果相似。这些发现表明,适度镇静可安全用于肥胖患者的内镜检查。