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Risk factors for hypoxemia during ambulatory gastrointestinal endoscopy in ASA I-II patients
Mohammed A Qadeer1, A Rocio Lopez, John A Dumot
1Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A 30, Cleveland, OH 44195, USA.
Background:
Most studies identify the American Society of Anesthesiology (ASA) classification as the most significant risk factor for hypoxemia. The risk factors operative within ASA I and II patients are not well defined. Therefore, we analyzed prospectively collected data to identify the risk factors of hypoxemia in such patients.
Methods:
A combination of a narcotic and benzodiazepine was used for sedation and oxygen was supplemented if hypoxemia (oxygen saturation
Results:
40 of 79 patients (51%) developed hypoxemia, which occurred more frequently in the obese (71%; 10/14) than the nonobese (46%; 30/65) group (P=0.08). On multivariate analysis, the odds ratios (OR) and 95% confidence intervals (CI) for developing hypoxemia were age >or= 60 years 4.5 (1.4-14.3) P=0.01, and incremental 25-mg doses of meperidine 2.6 (1.02-6.6) P = 0.04. Body mass index (BMI) significantly correlated with the number of hypoxemic episodes (rho 0.26, 95% CI 0.04-0.48, P=0.02).
Conclusion:
In ASA I and II patients, BMI significantly correlated with the number of hypoxemic episodes, whereas age >or= 60 years and meperidine dose were significant risk factors for hypoxemia.
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