Arterial desaturation during upper gastrointestinal endoscopy in nonsedated patients

Abstract

Introduction: Upper gastrointestinal endoscopy is the first and basic diagnostic procedure to diagnose mucosal disease of the esophagus, stomach, and duodenum, but arterial desaturation is a common occurrence during insertion of the scope and this can be detected by using pulse oximeter attaching with the finger during the procedure. Materials and Methods: In this prospective cross-sectional study done in MGM Medical College and LSK Hospital, Kishanganj, Bihar, India, 1814 patients underwent this procedure for diagnosis only in nonsedated condition only by oral anesthesia by xylocaine spray and pulse oximeter probe in the finger to monitor arterial oxygen saturation, pulse, and automated blood pressure monitor blood pressure. All the variables were measured before the procedure, at the insertion of the scope, during the procedure, and after the extubation of the scope. Results: Among 1814 patients aged under 50 years were 1137 (females = 494 and males = 643) and above 50 years were 677 (females = 307 and males = 370) with average hemoglobin of 11.9 gm%. During the insertion of the endoscope, there was sudden dipping of oxygen saturation in both the age groups more significantly in the case of the above 50 years of age group (P < 0.05) as compared to others. Systolic blood pressure also increased significantly during insertion (P > 0.05) in both the age groups as compared to baseline. But the pulse rate did not significantly increase as compared to the baseline rate prior to insertion in both groups. With the progress of endoscopy oxygen saturation both blood pressure came to normal but the pulse rate increased as compared to baseline. Conclusion: Common complication, arterial desaturation during endoscopy procedure can be recognized by pulse oximetry in nonsedated patient and this will prevent serious consequences. So monitoring with pulse oximetry is of prime importance in this routine procedure.