Unsedated flexible upper gastrointestinal endoscopy: need for routine oxygen monitoring?

Background: To determine the incidence of oxygen desaturation and whether routine oxygen monitoring is necessary during unsedated diagnostic flexible upper gastrointestinalendoscopy.

Methods: A prospective study involving 54 consecutive in and out patients who had diagnostic upper gastrointestinal endoscopy at the endoscopy suit of the Jos University Teaching Hospital, Jos, Nigeria between March 2007 and October 2007. The patients were reviewed before the procedure and classified according to the American Society of Anesthesiologists' (ASA) classification into classes I, II, III and IV Endoscopy was carried out after topical pharyngeal anaesthesia using 10% lidocaine spray and oxygen saturation was monitored throughout the procedure.

Results: There were 30 males and 24 females, with a male, female ratio of 1.25:1. The mean age was 46.7 with a range of 17 to 81 years. Mild to moderate desaturation occurred in 10 (18.5%) of the patients while severe desaturation occurred in 7 (12.9%) of the patients. All cases of severe desaturation lasted less than 30 seconds and no supplementary oxygen was needed. There were no significant statistical correlations between desaturation and gender, age, duration of procedure or ASA status of the patients.

Conclusion: Routine oxygen monitoring may not be necessary in patients undergoing unsedated diagnostic upper gastrointestinal endoscopy and who do not have respiratory disease.