Patients With Roux-en-Y Gastric Bypass Require Increased Sedation During Upper Endoscopy

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Pichamol JirapinyoChristopher C Thompson

Abstract

After Roux-en-Y gastric bypass (RYGB), many patients experience changes in metabolism that could affect the amount of sedative they require. We assessed whether patients who have vs have not received RYGB have different sedation requirements during esophagogastroduodenoscopy (EGD). In a retrospective study, we collected data from patients who had received RYGB (n = 200; mean age, 45 years; 188 women; body mass index [BMI], 34.0 ± 7.1 kg/m2) or had not (controls, n = 200; mean age, 45 years; 188 women; BMI, 34.1 ± 7.2 kg/m2) and underwent EGD under conscious sedation from 2005 through 2010; groups were matched for age, sex, and BMI. Sedative doses were compared by using the Student t test. Multivariate linear regression was used to identify factors associated with sedation dose. We performed a subgroup analysis of RYGB patients who underwent EGD before and after RYGB, comparing sedative doses with a paired t test. Patients with RYGB were given 132.4 ± 40.4 μg fentanyl and 5.4 ± 1.5 mg midazolam, whereas controls received 108.6 ± 31.6 μg fentanyl (P < .001) and 4.3 ± 1.2 mg midazolam (P < .001). Increased time from RYGB, higher American Society of Anesthesiologists class, and therapeutic procedure were associated with higher dose...Continue Reading

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Citations

Mar 24, 2016·Current Treatment Options in Gastroenterology·Katherine B HaganJohn Vargo
Jul 4, 2016·Gastrointestinal Endoscopy Clinics of North America·Pichamol Jirapinyo, Christopher C Thompson
Nov 23, 2019·Scandinavian Journal of Pain·Amalie H SimoniAnne E Olesen
Oct 12, 2018·Clinical Endoscopy·Pichamol Jirapinyo, Christopher C Thompson

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