Incidence and Risk Factors of Significant Unplanned Events During Anaesthesia-Assisted Gastrointestinal Endoscopy: A Prospective Observational Study
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Abstract
Introduction: Gastrointestinal (GI) endoscopy is essential for managing various GI conditions, particularly in critically ill patients. These procedures, often performed under anaesthesia, carry risks of significant unplanned events (SUEs), which can impact patient safety. This study assessed the incidence and risk factors of SUEs during anaesthesia-assisted GI endoscopy. Materials and Methods: A prospective observational study was conducted in a tertiary care center involving 170 adult patients undergoing elective or emergency GI endoscopy under anaesthesia. Demographic, clinical, and procedural data were collected using standardized forms. SUEs included airway obstruction, hypoxia, hypotension, bradycardia, and cardiac arrest. Statistical analyses were performed using SPSS v23 with p<0.05 as the threshold for significance. Results: Of 170 patients, 54.7% were male; the mean age was 43.3±16.7 years. Most were ASA Grade I or II. TIVA was the most common anaesthetic technique (57.6%). The overall SUE incidence was 9%, with hypoxia and hypotension each in 2.4%, bradycardia and airway obstruction in 1.8%, and cardiac arrest in 0.6%. Higher ASA grades, poor general condition, and CNS or respiratory findings were associated with more events. Conclusion: Though generally safe, GI endoscopy under anaesthesia can result in SUEs. Comprehensive monitoring, risk assessment, and standardised protocols are crucial to enhancing patient safety and outcomes.
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[1] Leslie K, Allen ML, Hessian EC, Peyton PJ, Kasza J, Courtney A, Dhar PA, Briedis J, Lee S, Beeton AR, Sayakkarage D, Palanivel S, Taylor JK, Haughton AJ, O'Kane CX. Safety of sedation for gastrointestinal endoscopy in a group of university-affiliated hospitals: a prospective cohort study. Br J Anaesth. 2017 Jan;118(1):90-99
[2] Sud S, Dwivedi D, Dudeja P, Hooda B, Singh S, Aggarwal M. A cross‑sectional study to compare anaesthesia techniques employed for the conduct of upper gastrointestinal endoscopic procedures in a gastroenterology suite of a tertiary care hospital. J Med Sci 41(4):p 167-172.
[3] Basavana Goudra, Preet Mohinder Singh Anaesthesia for gastrointestinal endoscopy: A subspecialty in evolution? Saudi J Anaesth. 2015 Jul-Sep; 9(3): 237–238.
[4] Goudra BG, Singh PM, Penugonda LC, Speck RM, Sinha AC. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect. J Anaesthesiol Clin Pharmacol. 2014;30:71
[5] Motiyaa Y, Bensghir M et al. Anaesthesia for endoscopic retrograde cholangiopancreatography; Target controlled infusion vs standard volatile anaesthesia. Ann Gastroenterol 2016;29:530-5.
[6] Daneshmend TK et al. sedation for upper gastrointestinal endoscopy: results of a nationwide survey. Gut 1991; 32:12-15.
[7] Arrowsmith J et al. results from the American society for gastrointestinal endoscopy/ US Food and Drug administration collaborative study on complication rates and drug use during gastrointestinal endoscopy. Gastrointestinal endoscopy 1991;37:421-7.
[8] MA Quine, et al. Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods. gut 1995;36:462-467