Gastrointestinal endoscopy
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Gastrointest. Endosc. · Jul 1992
Randomized Controlled Trial Comparative Study Clinical TrialOxygenating mouthguard alleviates hypoxia during gastroscopy.
A randomized study was carried out to determine the effect of oxygen (3 liters/min) via a novel oxygenating mouthguard (Oxyguard) on arterial oxygenation in 242 intravenously sedated patients undergoing gastroscopy. In another group of 21 patients, a randomized crossover study of arterial oxygen saturation using either the standard mouthguard or the oxygenating mouthguard (3 liters/min) was conducted. Significant O2 desaturation (pulse oximeter reading less than 90%) occurred in 25% of patients on room air but only 3% of those on oxygen (p less than 0.001). ⋯ In conclusion, administration of oxygen via the oxygenating mouthguard alleviates hypoxemia during gastroscopy and prevents severe oxygen desaturation. However, hypoxemia may occur even during use of supplemental oxygen. Hence, monitoring of arterial oxygenation is recommended.
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Gastrointest. Endosc. · Jul 1992
Randomized Controlled Trial Comparative Study Clinical TrialSupplemental low flow oxygen prevents hypoxia during endoscopic cholangiopancreatography.
Administration of continuous oxygen during ERCP may prevent hypoxia. Oxygen saturation was recorded using pulse oximetry in 50 consecutive patients undergoing ERCP. ⋯ No difference existed in oxygen saturations between those groups receiving supplemental oxygen via nasal prongs or nasopharyngeal cannula. Continuous administration of low flow oxygen is recommended during ERCP.
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Gastrointest. Endosc. · May 1992
Randomized Controlled Trial Comparative Study Clinical TrialUpper gastrointestinal endoscopy: a prospective randomized study comparing continuous supplemental oxygen via the nasal or oral route.
We have examined the efficacy of supplemental oxygen in preventing episodes of significant arterial desaturation (SpO2 less than 90%) during upper gastrointestinal endoscopy. We have compared the effects of 2 liters.min-1 of oxygen given orally via the bite-guard with the same flow rate via nasal cannulas and have also examined the effects of pre-oxygenation. Results of this study at a flow rate of 2 liters.min-1 have been compared with previously published results at a flow rate of 3 liters.min-1. ⋯ Pre-oxygenation significantly reduced episodes of desaturation (SpO2 less than 90%, p less than 0.01) and prevented SpO2 falls below 85% in all patients studied. Supplemental oxygen given at a rate of 2 liters.min-1 was as effective as that given at a rate of 3 liters.min-1 in preventing significant desaturation, as previously defined, during the procedure. We therefore recommend the use of supplemental oxygen at a flow rate of 2 liters.min-1 in all high risk patients and conclude that the oral route has practical advantages and is at least as effective as nasal cannulas.
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Gastrointest. Endosc. · May 1990
Randomized Controlled Trial Clinical TrialFlumazenil used for reversal of midazolam-induced sedation in endoscopy outpatients.
A double-blind, placebo-controlled randomized clinical study was performed in 69 outpatients scheduled for endoscopy and sedated with midazolam to assess the efficacy, safety, and usefulness of flumazenil in reversing the effects of midazolam-induced sedation. Midazolam was administered intravenously before endoscopy up to a maximum dose of 15 mg. After endoscopy either flumazenil or placebo was injected. ⋯ No rebound sedation was observed. Flumazenil is a safe and effective benzodiazepine antagonist. The combination of midazolam with flumazenil makes it possible to reduce the recovery period and is useful in outpatient endoscopy.