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Risk Factors and Outcomes of Reversal Agent Use in Moderate Sedation During Endoscopy and Colonoscopy
Adelina Hung1, John Marshall, Sheila Barnett
1Departments of *Gastroenterology ‡Anesthesiology †Division of Pharmacy, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA.
Journal of Clinical Gastroenterology
|January 29, 2015
Summary
Reversal agent use during moderate sedation for GI procedures is rare, affecting 0.03% of patients. Most patients recover well, but older individuals and those with higher ASA or Mallampati scores may need closer monitoring.
Area of Science:
- Gastroenterology and Endoscopy
- Anesthesiology and Sedation Management
Background:
- Moderate sedation is standard for gastrointestinal procedures.
- Data on reversal agent use and outcomes are limited.
Purpose of the Study:
- Determine the prevalence and clinical significance of reversal agent use during endoscopies and colonoscopies.
Main Methods:
- Identified patients requiring naloxone and/or flumazenil during GI procedures (2008-2013).
- Compared demographics and risk factors of reversal group with a matched control group.
Main Results:
- Prevalence of reversal agent use was 0.03%.
- Common indications included oxygen desaturation (64.4%) and respiratory changes (24.4%).
- Reversal group patients were older, more often female, and had higher ASA and Mallampati scores.
Conclusions:
- Reversal agent use in moderate sedation is infrequent with generally favorable outcomes.
- Identified risk factors suggest closer monitoring for specific patient groups.
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