Capnographic Monitoring of Moderate Sedation During Low-Risk Screening Colonoscopy Does Not Improve Safety or Patient Satisfaction: A Prospective Cohort Study

The American Journal of Gastroenterology
Sheila BarnettDaniel A Leffler

Abstract

Appropriate monitoring during sedation has been recognized as vital to patient safety in procedures outside of the operating room. Capnography can identify hypoventilation prior to hypoxemia; however, it is not clear whether the addition of capnography improves safety or is cost effective during routine colonoscopy, a high volume, low-risk procedure. Our aim was to evaluate the value of EtCO2 monitoring during colonoscopy with moderate sedation. We conducted a prospective study of sedation safety and patient satisfaction before and after the introduction of EtCO2 monitoring during outpatient colonoscopy with midazolam and fentanyl using the validated PROcedural Sedation Assessment Survey (PROSAS). Complications of sedation and PROSAS scores were compared among colonoscopies with and without capnography. A total of 966 patients participated in our study, 465 in the pre-EtCO2 group and 501 in the EtCO2 group. On multivariate analysis, patients and nurses reported higher levels of procedural discomfort after adoption of capnography (1.71 vs. 1.00, P<0.001). No serious adverse events were seen, and minor sedation-related adverse events occurred with similar frequency in both groups (8.2% pre-EtCO2 vs. 11.2% EtCO2, P=0.115). The cos...Continue Reading

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Citations

Sep 24, 2016·Gastrointestinal Endoscopy·Amit Rastogi, Sachin Wani
May 17, 2017·Current Opinion in Anaesthesiology·Megan L Allen
Jun 6, 2018·Current Opinion in Anaesthesiology·Joshua W Sappenfield, Jeffrey D White
May 30, 2017·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Julio López-PicazoFrancisco Javier Júdez
May 26, 2017·Journal of Clinical Monitoring and Computing·Wei-Nung TengChun-Li Lin
Mar 17, 2021·Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS·Peter H Tonner
Jun 26, 2021·Digestive Diseases and Sciences·Brian M FungJames H Tabibian

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