Sedação consciente para endoscopia digestiva alta realizada por médicos endoscopistas

Ana Laura Colle Kauling; Giovani de Figueiredo Locks; Guilherme Muriano Brunharo; Viriato João Leal da Cunha; Maria Cristina Simões de Almeida

doi:10.1590/S0034-70942010000600003

Scientific Article

Sedação consciente para endoscopia digestiva alta realizada por médicos endoscopistas

Conscious sedation for upper digestive endoscopy performed by endoscopists

Ana Laura Colle Kauling; Giovani de Figueiredo Locks; Guilherme Muriano Brunharo; Viriato João Leal da Cunha; Maria Cristina Simões de Almeida

http://dx.doi.org/10.1590/S0034-70942010000600003 Braz J Anesthesiol, vol.60, n6, p.580-583, 2010

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Resumo

JUSTIFICATIVA E OBJETIVOS: A sedação consciente na prática ambulatorial, embora comum, não é isenta de riscos. Este trabalho teve por objetivo avaliar a pressão arterial, a frequência cardíaca e a saturação periférica de oxigênio em pacientes submetidos à sedação consciente para endoscopia digestiva alta, realizada por médicos endoscopistas. MÉTODOS: Foram selecionados 105 pacientes de ambos os sexos, com idade mínima de 18 anos, estado físico ASA I a III, submetidos a endoscopia digestiva alta sob sedação consciente. Os pacientes foram monitorados com medidas de pressão arterial não invasiva, oximetria de pulso e frequência cardíaca, registradas antes, durante e após o exame. A sedação foi administrada com os fármacos midazolam e/ou meperidina. RESULTADOS: As variações de saturação de oxigênio, pressão arterial e frequência cardíaca ao longo do tempo não foram estatisticamente significativas. Entretanto, observou-se incidência de hipóxia de 41,9%; em 53,3% dos casos, houve hipotensão arterial e taquicardia em 25,6%. Os pacientes obesos demonstraram-se mais suscetíveis à hipóxia e à hipotensão que aqueles não obesos. CONCLUSÕES: A ocorrência de hipóxia e hipotensão arterial é comum nos exames de endoscopia digestiva alta sob sedação consciente quando utilizados midazolam e meperidina associados. Pacientes obesos demonstraram-se mais suscetíveis à hipoxemia e à hipotensão arterial.

Palavras-chave

COMPLICAÇÕES, COMPLICAÇÕES, EXAMES DIAGNÓSTICOS, endoscopia digestiva, MEDICAÇÃO PRÉ-ANESTÉSICA, MEDICAÇÃO PRÉ-ANESTÉSICA, SEDAÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Conscious sedation in the ambulatory setting albeit common is not risk-free. The present study aimed at evaluating the blood pressure, heart rate and peripheral oxygen saturation in patients submitted to conscious sedation for upper digestive endoscopy performed by endoscopists. METHODS: A total of 105 patients of both sexes were selected, aged 18 and older, physical status ASA I to III, submitted to upper digestive endoscopy under conscious sedation. The patients were monitored through noninvasive blood pressure measurements, pulse oximetry and heart rate recorded before, during and after the examination. The sedation was carried out with midazolam or meperidine. RESULTS: The variations in oxygen saturation, blood pressure and heart rate throughout time were not statistically significant. However, an incidence of hypoxia of 41.9% was observed; 53.3% of the cases presented arterial hypotension and 25.6% presented tachycardia. Obese patients were more prone to hypoxia and hypotension than those non obese. CONCLUSIONS: The occurrence of hypoxia and arterial hypotension is common in upper digestive endoscopic examinations under conscious sedation when midazolam and meperidine are associated. Obese patients demonstrated to be more susceptible to hypoxemia and arterial hypotension.

Keywords

COMPLICATIONS, COMPLICATIONS, DIAGNOSTIC ASSESSMENT, digestive endoscopy, PRE-ANESTHETIC MEDICATION, PRE-ANESTHETIC MEDICATION, SEDATION

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Sedação consciente para endoscopia digestiva alta realizada por médicos endoscopistas

Conscious sedation for upper digestive endoscopy performed by endoscopists

Ana Laura Colle Kauling; Giovani de Figueiredo Locks; Guilherme Muriano Brunharo; Viriato João Leal da Cunha; Maria Cristina Simões de Almeida

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