Airway complications during gastrointestinal endoscopies using propofol in a rural hospital

  • Kelsey S. Flores Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • Jungbin A. Choi Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • Kathleen N. Johnson Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • David P. Vaneenenaam Jr. Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • Hannah M. Harris East Carolina University Brody School of Medicine, Greenville, North Carolina, USA.
  • Daniel J. Forest Department of Anesthesiology, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, USA.
  • Yvon F. Bryan Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
DOI: https://doi.org/10.35975/apic.v24i4.1314
Keywords: gastrointestinal endoscopy, propofol, endoscopic procedures, anesthesia, rural health, desaturations

Abstract

Background: Simple endoscopies such as esophagogastroduodenoscopy (EGD) and colonoscopies are common procedures that require the use of sedation or general anesthesia. The risk of airway complications for these procedures depends on the type of medications administered. Wide variation exists in reported rates of airway complications for endoscopic procedures. This retrospective study analyzed airway interventions and desaturations during simple endoscopy procedures performed by anesthesia-based teams (ABT) using propofol in a rural hospital.

Methodology: An IRB approved retrospective study was conducted at Wake Forest Baptist Lexington Medical Center (LMC). Patients over age 18 who underwent an EGD, colonoscopy, or both from July to December 2017 were included. Demographics, comorbidities, airway interventions, incidence of desaturation, the mean doses of propofol, and duration of procedures were recorded.

Results: Five hundred and thirteen patients underwent simple endoscopies (130 EGD, 320 colonoscopies, and 63 EGD/colonoscopy) at LMC. No patients required rescue intubation. One (0.2%) patient required BMV, three (0.6%) required a nasal airway, and three (0.6%) required an oral airway. 44 patients desaturated; 11 (25%) were severe and 33 (75%) moderate.

Conclusion: We found that simple endoscopies performed by ABT had a low rate of airway interventions; however, the incidence of desaturation was higher than reported by other non-anesthesia-based teams and/or when clinicians used propofol for the endoscopies.

Key words: gastrointestinal endoscopy, endoscopic procedures, propofol, anesthesia, rural health, desaturations

Citation: Flores KS, Choi JA, Johnson KN, Vaneenenaam Jr. DP, Harris HM, Forest DJ, Bryan YF. Airway complications during gastrointestinal endoscopies using propofol in a rural hospital. Anaesth. pain intensive care 2020;24(4):420-425.

Received: 15 March 2020, Reviewed: 17 June 2020, Accepted: 27 June 2020

 

Published
09-02-2020
How to Cite
Flores, K. S., Choi, J. A., Johnson, K. N., Vaneenenaam Jr., D. P., Harris, H. M., Forest, D. J., & Bryan, Y. F. (2020). Airway complications during gastrointestinal endoscopies using propofol in a rural hospital. Anaesthesia, Pain & Intensive Care, 24(4), 420-425. https://doi.org/10.35975/apic.v24i4.1314
Issue
Vol 24 No 4 (2020): August 2020
Section
ORIGINAL RESEARCH