Arterial oxygen saturation during unsedated upper endoscopy

Aim: to determine the incidence of hypoxia,to identify the clinical value of pulse oximetry during unsedated endoscopy. methods: a prospective study conducted at al-kuwait university teaching hospital,and police typical hospital,sana'a. sixty eight consecutive patients underwent upper gastrointestinal endoscopy (ugie) were enrolled in the study. arterial oxygen saturation,pulse rate and blood pressure were monitored with continuous pulse oximetry and automated blood pressure monitor before the procedure,at regular intervals during the procedure,during initial recovery and upto 10minutes after the procedure. we study the effect of risk factors on oxygen desaturation in unsedated upper endoscopy to determine whether or not pulseoximetry is useful. results: mean age of the patients was47.06±12.45 (53 men and 15 female). mean endoscopic time was14.71±4.81 minutes (ranged from 10 to 38 minutes). cardiopulmonary changes observed during the present study were transient and of no disastrous consequences. mildoxygen desaturation was observed in13 patients (19.1%).severe hypoxia (sao<85%) was rare episode (1.47%).three patients (4.4%) suffered significant decrease in oxygen desaturation and required oxygen supplementation. mean oxygen saturation before the procedures,during insertion of the endoscope,during scoping,and after procedure were 95.65±2.58,91.44±2.63,92.43±2.65 and 94.25±2.44 respectively. oxygen saturation decreased significantly during probe insertion,during scoping of endoscope,and after procedure as compared with baseline oxygen level (p<0.05). the changes in oxygen saturation were significant during endoscopic insertion in patients ≥50 years when compared to those <50 years (p<0.05). conclusions: mild hypoxemiais common adverse event during non-sedated endoscopic procedure and of no disastrous consequences. furthermore,oxygen desaturation developed during the endoscope may have resulted in undetected hypoxemia with serious consequences. we recommend pulseoximetry monitoring in patients at risk for desaturation. patients at risk are elderly and patients with respiratory diseases.