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. 1994 Mar;35(3):408–411. doi: 10.1136/gut.35.3.408

Oxygen saturation during endoscopic retrograde cholangiopancreatography: a comparison of two protocols of oxygen administration.

J D Rigg 1, T C Watt 1, D E Tweedle 1, D F Martin 1
PMCID: PMC1374600  PMID: 8150356

Abstract

Patients having endoscopic retrograde cholangiopancreatography (ERCP) are generally elderly and require sedation while in the prone position. These factors may be expected to aggravate any risk of arterial hypoxia. This study evaluated two protocols of oxygen administration, one with and one without pre-oxygenation. In 25 patients in whom pre-oxygenation with 4 litres/minute for five minutes before sedation was used, followed by continuous oxygen administration, arterial oxygen saturation did not fall below 90% at any stage during the procedure. By contrast, in 25 patients who were not pre-oxygenated oxygen saturation fell below 90% in nine (36%). As expected, hypoxia occurred most frequently during the early stages of sedation and endoscope insertion. Hypoxia did not occur in association with operations such as sphincterotomy, stone extraction or stent insertion. This study confirms that arterial hypoxia is a common event during ERCP and can be completely prevented by pre-oxygenation with four litres of oxygen given intranasally for five minutes before sedation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell G. D., Bown S., Morden A., Coady T., Logan R. F. Prevention of hypoxaemia during upper-gastrointestinal endoscopy by means of oxygen via nasal cannulae. Lancet. 1987 May 2;1(8540):1022–1024. doi: 10.1016/s0140-6736(87)92282-3. [DOI] [PubMed] [Google Scholar]
  2. Bell G. D., McCloy R. F., Charlton J. E., Campbell D., Dent N. A., Gear M. W., Logan R. F., Swan C. H. Recommendations for standards of sedation and patient monitoring during gastrointestinal endoscopy. Gut. 1991 Jul;32(7):823–827. doi: 10.1136/gut.32.7.823. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Daneshmend T. K., Bell G. D., Logan R. F. Sedation for upper gastrointestinal endoscopy: results of a nationwide survey. Gut. 1991 Jan;32(1):12–15. doi: 10.1136/gut.32.1.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Griffin S. M., Chung S. C., Leung J. W., Li A. K. Effect of intranasal oxygen on hypoxia and tachycardia during endoscopic cholangiopancreatography. BMJ. 1990 Jan 13;300(6717):83–84. doi: 10.1136/bmj.300.6717.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Haines D. J., Bibbey D., Green J. R. Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography? Gut. 1992 Jul;33(7):973–975. doi: 10.1136/gut.33.7.973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. McCarthy G., Elliott P., Mirakhur R. K., McLoughlin C. A comparison of different pre-oxygenation techniques in the elderly. Anaesthesia. 1991 Oct;46(10):824–827. doi: 10.1111/j.1365-2044.1991.tb09593.x. [DOI] [PubMed] [Google Scholar]
  7. Murray A. W., Morran C. G., Kenny G. N., Macfarlane P., Anderson J. R. Examination of cardiorespiratory changes during upper gastrointestinal endoscopy. Comparison of monitoring of arterial oxygen saturation, arterial pressure and the electrocardiogram. Anaesthesia. 1991 Mar;46(3):181–184. doi: 10.1111/j.1365-2044.1991.tb09404.x. [DOI] [PubMed] [Google Scholar]
  8. Valentine S. J., Marjot R., Monk C. R. Preoxygenation in the elderly: a comparison of the four-maximal-breath and three-minute techniques. Anesth Analg. 1990 Nov;71(5):516–519. doi: 10.1213/00000539-199011000-00011. [DOI] [PubMed] [Google Scholar]

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