• Christian M Andrade, Brijesh Patel, Jeffrey Gill, Donald Amodeo, Prasad Kulkarni, Susan Goldsmith, Barbara Bachman, Reynaldo Geerken, Malcolm Klein, William Anderson, Branko Miladinovic, Ileana Fernandez, Ambuj Kumar, Joel Richter, and Gitanjali Vidyarthi.
• *Department of Gastroenterology, The James A. Haley Veterans Affairs Hospital †Division of Digestive Diseases and Nutrition, University of South Florida, Tampa, FL.
• J. Clin. Gastroenterol. 2016 Mar 1; 50 (3): 198-201.

Background And Study AimsPatients with obstructive sleep apnea (OSA) undergoing endoscopy with sedation are considered by practitioners to be at a higher risk for cardiopulmonary complications. The aim of the present study was to evaluate the safety of conscious sedation in patients with OSA undergoing gastrointestinal endoscopy.Patients And MethodsThis is an IRB-approved prospective cohort study performed at the James A. Haley VA. A total of 248 patients with confirmed moderate or severe OSA by polysomnography and 252 patients without OSA were enrolled. Cardiopulmonary variables such as heart rate, blood pressure, and level of blood oxygen saturation were recorded at 3-minute intervals throughout the endoscopic procedure.ResultsIn total, 302 colonoscopies, 119 esophagogastroduodenoscopies, 6 flexible sigmoidoscopies, and 60 esophagogastroduodenoscopy/colonoscopies were performed. None of the patients in the study required endotracheal intubation, pharmacologic reversal, or experienced an adverse outcome as a result of changes in blood pressure, heart rate, or blood oxygen saturation. There were no significant differences in the rate of tachycardia (P=0.749), bradycardia (P=0.438), hypotension (systolic/diastolic, P=0.460; mean arterial pressure, P=0.571), or hypoxia (P=0.787) between groups. The average length of time spent in each procedure and the average dose of sedation administered also did not differ significantly between the groups.ConclusionsDespite the presumed increased risk of cardiopulmonary complications, patients with OSA who undergo endoscopy with conscious sedation have clinically insignificant variations in cardiopulmonary parameters that do not differ from those without OSA. Costly preventative measures in patients with OSA are not warranted.

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