BACKGROUND: Deep sedation is increasingly used for endoscopy. The impact of sedation level on hemodynamic status, oxygenation, and aspiration risk is incompletely described. AIMS: To describe the incidence of intraprocedural cough, hemodynamic changes, @entity26 desaturation, and their relationship to clinical factors and sedation level. METHODS: Detailed prospective recordings of hemodynamic changes, @entity26 desaturation, and cough during 757 nonemergent endoscopic procedures done under sedation using @entity1875 , @entity1363 , and/or @entity3575 . RESULTS: Thirteen percent of @entity1 had at least one cough and 3% had prolonged cough. Cough was more common in nonsmokers (P = 0.05), upper endoscopy (P < 0.0001), with @entity1875 (P = 0.0008), longer procedures (P = 0.0001), and @entity11637 (P = 0.01). The association between supine positioning during colonoscopy and cough approached significance (P = 0.06). @entity26 desaturation was rare (4%) and associated only with deep sedation (P = 0.02). Mean systolic and diastolic blood pressure (BP) dropped by 7.3 and 5.6% respectively. @entity551 were more common in whites (P = 0.03), males (P = 0.004), nonsmokers (P = 0.04), during colonoscopy (P < 0.0001), and in @entity1 receiving @entity1363 and @entity3575 (P = 0.01). Heart rate (HR) dropped >20% from baseline in 15% of @entity1 and was more common during colonoscopy (P = 0.002). HR increased >20% in 20% of @entity1 and was more common with coughing (P < 0.0001) and in younger @entity1 (P = 0.0002). No @entity1 required pharmacologic treatment of BP or HR. CONCLUSIONS: We have described procedural predictors of cough that may help clinicians reduce the risk of aspiration during endoscopy. Hemodynamic changes during endoscopy are common but largely clinically insignificant.

Prospective description of coughing, hemodynamic changes, and XXXX desaturation during endoscopic sedation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen', 'Oxygen'] @entity11637 :: ('MESH:D006606', 'Disease') :: ['hiccups'] @entity1875 :: ('MESH:D015742', 'Chemical') :: ['propofol'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam'] @entity551 :: ('MESH:D007022', 'Disease') :: ['Decreases in systolic BP'] @entity3575 :: ('MESH:D005283', 'Chemical') :: ['fentanyl']
@entity26 :: (MESH:D010100,Chemical) :: ['oxygen']
