The Effects of Obesity on Sedation-related Outcomes of Advanced Endoscopic Procedures

Overview

Journal North Clin Istanb

Publisher Kare Publishing

Specialty General Medicine

Date 2020 Jan 8

PMID 31909375

Citations 7

Authors

Ebru Tarikci Kilic

Suleyman Sayar

Resul Kahraman

Kamil Ozdil

Affiliations

Soon will be listed here.

Abstract

Objective: Current literature covers limited data on the safety of sedation in advanced endoscopic procedures in obese patients. The present study aims to evaluate the association between obesity and the frequency of sedation-related complications in patients who were undergoing advanced endoscopic procedures.

Methods: A retrospective chart analysis of 1172 consecutive patients, meeting the inclusion and exclusion criteria for this study and undergoing intravenous ketamine-propofol (ketofol) sedation for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) procedures were evaluated. The patients were classified into three groups according to their body mass index (BMI) (kg/m2). Group I comprised patients with a BMI between 25 and 30, group II with a BMI between 30 and 35, and group III with a BMI between 35-40. The sedation-related outcomes in the form of adverse events, and airway interventions were compared between the groups.

Results: For analysis, out of the 1172 available records, 289 patients had a BMI between 35-40 and were predominantly male patients. The total adverse events were more common in obese patients, with apnea (in 5.5% patients in group I, 5.7% in group II, 22.8% in group III p<0.000), oxygen desaturation (in 7.7% patients in group I, 9.4% in group II, and 27.7% in group III p<0.000), and airway obstruction (in 4.9% patients in group I, 5.4% in group II, 22.8% in group III, p<0.000). Moreover, the obese patients more frequently required airway interventions, including airway placement, suctioning and bag-mask ventilation.

Conclusion: Higher BMI was associated with an increased frequency of sedation-related complications. However, we concluded that ketofol sedation regimen could be used safely in obese patients during advanced endoscopic procedures by skilled anesthesia providers.

Citing Articles

Sedation for GI Endoscopy in the Morbidly Obese: Challenges and Possible Solutions.

Sundararaman L, Goudra B J Clin Med. 2024; 13(16).

PMID: 39200777 PMC: 11354526. DOI: 10.3390/jcm13164635.

Sedation reversal trends at outpatient ambulatory endoscopic center in-hospital ambulatory procedure center using a triage protocol.

Walayat S, Stadmeyer P, Hameed A, Sarfaraz M, Estrada P, Benson M World J Gastrointest Endosc. 2024; 16(7):413-423.

PMID: 39072249 PMC: 11271719. DOI: 10.4253/wjge.v16.i7.413.

Patient Safety during Propofol Sedation before and after Implementation of Capnography Monitoring.

Baytas V, Vural C, Ozcelik M, Torrejon Torres R, Saunders R, Alkis N J Clin Med. 2023; 12(18).

PMID: 37762900 PMC: 10531740. DOI: 10.3390/jcm12185959.

Global Trends of Gastrointestinal Endoscopy Anesthesia/Sedation: A Bibliometric Study (from 2001 to 2022).

Xiong Y, Yan H, Qu L, Wang S, Meng X, Zhu X J Pain Res. 2023; 16:2393-2406.

PMID: 37483407 PMC: 10356960. DOI: 10.2147/JPR.S408811.

Procedural and outcome impact of obesity in cryoballoon versus radiofrequency pulmonary vein isolation in atrial fibrillation patients.

Scheurlen C, van den Bruck J, Filipovic K, Wormann J, Arica Z, Erlhofer S J Interv Card Electrophysiol. 2022; 65(2):403-410.

PMID: 35415815 PMC: 9640436. DOI: 10.1007/s10840-022-01210-3.

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