HOW ADEQUATE IS PREOXYGENATION BEFORE ENDOSCOPIC SEDATION IN REDUCING HYPOXEMIA: IS ONE MINUTE OR TWO MINUTES ENOUGH?
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Abstract
Objective: To evaluate the effectiveness of pre-endoscopy oxygen therapy in reducing the complication of hypoxemia during sedated upper gastrointestinal endoscopy.
Method: This was a prospective study. A total of 1004 patients underwent sedated upper gastrointestinal endoscopy using Propofol at the Department of Gastrointestinal Endoscopy, 108 Military Central Hospital, from September to December 2024. Patients were divided into 3 groups: no pre-endoscopy oxygen therapy (control group, 364 patients), 1-minute pre-endoscopy oxygen therapy (Group 1; 314 patients), and 2-minute pre-endoscopy oxygen therapy (Group 2; 326 patients). Hypoxemia was defined as an SpO₂ level below 90% at any point during the endoscopy.
Result: The hypoxemia rate was 14.6% in the control group, 10.5% in the 1-minute oxygen group, and 7.7% in the 2-minute oxygen group (p < 0.05). Risk factors for hypoxemia included age ≥ 60 years and Mallampati score of III or IV. Patients with multiple risk factors had a higher likelihood of hypoxemia during endoscopy. There was a significant difference in hypoxemia rates between the control group and the 2-minute oxygen group, with an odds ratio (OR) of 2.05 (95% CI: 1.24–3.39).
Conclusion: The incidence of hypoxemia during sedated upper GI endoscopy is higher in elderly patients or those with Mallampati class III or IV. However, administering oxygen for 2 minutes before the procedure significantly reduces the risk of this complication.
Keywords
hypoxia, sedation gastrointestinal endoscopy, pre-endoscopy oxygen therapy, Mallampati grade
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References
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