Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation
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Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. Theadministration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has beenincreasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopistsatisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally impliesdeep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritableairway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention ofhypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, itcannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers havestepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminatedead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of thesedevices.
Abstract
Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. Theadministration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has beenincreasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopistsatisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally impliesdeep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritableairway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention ofhypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, itcannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers havestepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminatedead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of thesedevices.
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