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Oxygen supplementation during upper gastrointestinal endoscopy: a comparison of two methods
G S Hebbard1, C F Royse, A R Bjorksten
1Department of Gastroenterology, Royal Melbourne Hospital, Australia.
Endoscopy
|March 1, 1994
Summary
Oxygen supplementation via nasal prongs or oropharyngeal catheter is equally effective during upper endoscopy. Supplementary oxygen significantly reduces critical desaturations, even in healthy patients.
Area of Science:
- Gastroenterology
- Anesthesiology
- Respiratory Physiology
Background:
- Optimal oxygen supplementation during upper gastrointestinal endoscopy remains undefined.
- Mouth breathing can affect oxygenation during endoscopic procedures.
- Patient risk stratification is crucial for managing oxygenation during endoscopy.
Purpose of the Study:
- To compare the efficacy of nasal prongs versus oropharyngeal catheter for oxygen supplementation during upper endoscopy.
- To evaluate the impact of oxygen supplementation on arterial oxygen saturation (SpO2) in patients undergoing endoscopy.
- To assess differences in desaturation events between lower-risk and higher-risk patient groups.
Main Methods:
- Patients were stratified by American Society of Anesthesiologists (ASA) physical status (lower-risk: ASA 1-2; higher-risk: ASA 3).
- Oxygen was administered via intranasal prongs or an intrapharyngeal catheter, with a control group receiving no oxygen.
- Continuous SpO2 monitoring was performed before and during endoscopy, analyzing critical desaturations (SpO2 ≤ 90%).
Main Results:
- No significant difference in desaturation rates or SpO2 levels was observed between intranasal and intrapharyngeal oxygen supplementation.
- Patients receiving no supplementary oxygen experienced significantly higher rates of desaturation (37%) compared to those receiving oxygen (2%, p < 0.001).
- Supplementary oxygen led to higher minimum SpO2 (97% vs 91%, p < 0.001) and reduced maximum desaturation from baseline (-0.7% vs -5.2%, p < 0.001).
Conclusions:
- Intranasal and intrapharyngeal oxygen supplementation demonstrate similar efficacy during upper gastrointestinal endoscopy.
- Supplementary oxygen significantly reduces the incidence of critical arterial oxygen desaturation in patients undergoing endoscopy.
- Even healthy patients undergoing upper endoscopy benefit from supplementary oxygen to maintain adequate SpO2 levels.