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. 2017 Nov 16;9(11):552-557.
doi: 10.4253/wjge.v9.i11.552.

Safety of gastrointestinal endoscopy with conscious sedation in obstructive sleep apnea

Christian M Andrade  1 , Brijesh Patel  1 , Meghana Vellanki  2 , Ambuj Kumar  3 , Gitanjali Vidyarthi  1
Affiliations

Safety of gastrointestinal endoscopy with conscious sedation in obstructive sleep apnea

Christian M Andrade et al. World J Gastrointest Endosc. .

Abstract

Aim: To perform a systematic review and meta-analysis to assess the safety of conscious sedation in patients with obstructive sleep apnea (OSA).

Methods: A comprehensive electronic search of MEDLINE and EMBASE was performed from inception until March 1, 2015. In an effort to include unpublished data, abstracts from prior gastroenterological society meetings as well as other reference sources were interrogated. After study selection, two authors utilizing a standardized data extraction form collected the data independently. Any disagreements between authors were resolved by consensus among four authors. The methodological quality was assessed using the Newcastle Ottawa tool for observational studies. The primary variables of interest included incidence of hypoxia, hypotension, tachycardia, and bradycardia. Continuous data were summarized as odds ratio (OR) and 95%CI and pooled using generic inverse variance under the random-effects model. Heterogeneity between pooled studies was assessed using the I2 statistic.

Results: Initial search of MEDLINE and EMBASE identified 357 citations. A search of meeting abstracts did not yield any relevant citations. After systematic review and exclusion consensus meetings, seven studies met the a priori determined inclusion criteria. The overall methodological quality of included studies ranged from moderate to low. No significant differences between OSA patients and controls were identified among any of the study variables: Incidence of hypoxia (7 studies, 3005 patients; OR = 1.11; 95%CI: 0.73-1.11; P = 0.47; I2 = 0%), incidence of hypotension (4 studies, 2125 patients; OR = 1.10; 95%CI: 0.75-1.60; P = 0.63; I2 = 0%), incidence of tachycardia (3 studies, 2030 patients; OR = 0.94; 95%CI: 0.53-1.65; P = 0.28; I2 = 21%), and incidence of bradycardia (3 studies, 2030 patients; OR = 0.88; 95%CI: 0.63-1.22; P = 0.59; I2 = 0%).

Conclusion: OSA is not a significant risk factor for cardiopulmonary complications in patients undergoing endoscopic procedures with conscious sedation.

Keywords: Complications; Conscious sedation; Endoscopy; Meta-analysis; Obstructive sleep apnea; Safety.

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Conflict of interest statement

Conflict-of-interest statement: The authors deny any conflict of interest. This manuscript is not under consideration elsewhere.

Figures

Figure 1
Figure 1
Flow diagram of study selection[22-25]. OSA: Obstructive sleep apnea.
Figure 2
Figure 2
Incidence of hypoxia[8,17-21].
Figure 3
Figure 3
Incidence of hypotension[8,17,20,21].
Figure 4
Figure 4
Incidence of tachycardia[8,20,21].
Figure 5
Figure 5
Incidence of bradycardia[8,20,21].
See this image and copyright information in PMC

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