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Predictor of respiratory disturbances during gastric endoscopic submucosal dissection under deep sedation

World Journal of Gastrointestinal Endoscopy 2020年第10期12卷 378-387页

作者： Mizuho Aikawa Masaya Uesato Ryuma Urahama Koichi Hayano Reiko Kunii Yohei Kawasaki Shiroh Isono Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of MedicineChiba 260-8670Japan Staff of Clinical Laboratory Seirei Sakura Citizen HospitalChiba 285-8765Japan Biostatistics Section Clinical Research CenterChiba University HospitalChiba 260-8677Japan Department of Anesthesiology Chiba University Graduate School of MedicineChiba 260-8670Japan

BACKGROUND sedation is commonly performed for the endoscopic submucosal dissection(ESD)of early gastric *** hypoxemia occasionally occurs due to the respiratory depression during *** To establish predictive models for respiratory depression during sedation for *** Thirty-five adult patients undergoing sedation using propofol and pentazocine for gastric ESDs participated in this prospective observational ***,a portable sleep monitor and STOP questionnaires,which are the established screening tools for sleep apnea syndrome,were *** during sedation was assessed by a standard polysomnography technique including the pulse oximeter,nasal pressure sensor,nasal thermistor sensor,and chest and abdominal respiratory motion *** apnea-hypopnea index(AHI)was obtained using a preoperative portable sleep monitor and polysomnography during ESD.A predictive model for the AHI during sedation was developed using either the preoperative AHI or STOP questionnaire *** All ESDs were completed successfully and without *** patients(49%)had a preoperative AHI greater than 5/*** intraoperative AHI was significantly greater than the preoperative AHI(12.8±7.6 events/h vs 9.35±11.0 events/h,P=0.049).Among the potential predictive variables,age,body mass index,STOP questionnaire score,and preoperative AHI were significantly correlated with AHI during *** linear regression analysis determined either STOP questionnaire score or preoperative AHI as independent predictors for intraoperative AHI≥30/h(area under the curve[AUC]:0.707 and 0.833,respectively)and AHI between 15 and 30/h(AUC:0.761 and 0.778,respectively).CONCLUSION The cost-effective STOP questionnaire shows performance for predicting abnormal breathing during sedation for ESD that was equivalent to that of preoperative portable sleep monitoring.

关键词： deep sedation Respiratory depression Polysomnography Endoscopic submucosal dissection Sleep apnea syndrome STOP questionnaire

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