• M Jeffery Mador, Mohammed Abo Khamis, Namrata Nag, Amjad Mreyoud, Shais Jallu, and Shahid Mehboob.
• Western New York Veteran Affairs Healthcare System, Buffalo, NY, USA. mador@buffalo.edu
• Sleep Breath. 2011 Sep 1;15(3):393-401.

BackgroundPatients with obstructive sleep apnea (OSA) have an increased risk of perioperative complications.AimThe purpose of this study is to assess whether OSA increases the risk of cardiorespiratory complications in patients undergoing endoscopic procedures.MethodsA retrospective study was performed. We identified all patients who had undergone both an endoscopic procedure under conscious sedation and a sleep study from January 2001 to May 2008. Patients were divided into four groups: OSA negative (apnea-hypopnea index (AHI) < 5/h), OSA positive; mild: AHI 5-15/h, moderate: AHI 15.1-30/h, and severe: AHI > 30/h. Minor and major complications were identified. The minor ones were hypertension, hypotension, bradycardia, tachycardia, oxygen desaturation (<90%), and bradypnea. Major complications included chest pain, respiratory distress, cardiorespiratory arrest, or any minor complication that required intervention.ResultsProcedures were performed in 639 patients: colonoscopies 68.5%, upper endoscopies 20.2%, and combined procedures 11.3%. The mean age was 60.5 years, mean body mass index 33.7, and 93% were males. Sleep study results: 130 negative, 509 positive; 135 mild, 125 moderate, and 249 severe. Of the patients, 19% had minor complications, while 7% had major complications. There was no significant difference between the patients with and without OSA in the rate of minor complications (odds ratio 1.17, 95% confidence interval 0.70-1.92) or major complications (odds ratio 1.19, 95% confidence interval 0.54-2.63). The odds ratio was also not significantly increased when a cutoff value of 10 or 15/h was used to delineate a positive sleep study.ConclusionFor patients undergoing endoscopy procedures under conscious sedation, the presence of OSA does not clearly increase the risk of cardiorespiratory complications.

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