Polysomnographic assessment of respiratory disturbance during deep propofol sedation for endoscopic submucosal dissection of gastric tumors

• 作者: Hisahiro Matsubara Koichi Hayano Makoto Arai Masaya Uesato Mizuho Aikawa Reiko Kunii Ryuma Urahama Shiroh Isono Tomoaki Matsumura Yukiko Yamaguchi
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: POLYSOMNOGRAPHY HYPOXEMIA PROPOFOL Endoscopic SUBMUCOSAL dissection Pulse OXIMETRY SEDATION
• 年，卷（期）: 2018,（11）
• 页码范围: 340-347
• 页数: 8页
• 分类号: R

摘要

AIM To investigate that polysomnographic monitoring can accurately evaluate respiratory disturbance incidence during sedation for gastrointestinal endoscopy compare to pulse oximetry alone.METHODS This prospective observational study included 10 elderly patients with early gastric cancer undergoing endoscopic submucosal dissection(ESD)under propofol sedation.Apart from routine cardiorespiratory monitoring,polysomnography measurements were acquired.The primary hypothesis was tested by comparing the apnea hypopnea index(AHI),defined as the number of apnea and hypopnea instances per hour during sedation,with and without hypoxemia;hypoxemia was defined as the reduction in oxygen saturation by≥3%from baseline.RESULTS Polysomnography(PSG)detected 207 respiratory disturbances in the 10 patients.PSG yielded a significantly greater AHI(10.44±5.68/h)compared with pulse oximetry(1.54±1.81/h,P<0.001),thus supporting our hypothesis.Obstructive AHI(9.26±5.44/h)was significantly greater than central AHI(1.19±0.90/h,P<0.001).Compared with pulse oximetry,PSG detected the 25 instances of respiratory disturbances with hypoxemia 107.4 s earlier on average.CONCLUSION Compared with pulse oximetry,PSG can better detect respiratory irregularities and thus provide superior AHI values,leading to avoidance of fatal respiratory complications during ESD under propofol-induced sedation.