Cardiorespiratory Complications During Moderate and Deep Sedation for Gastrointestinal Endoscopic Procedures

Somchai Amornyotin
  • March 2013, InTech
  • DOI: 10.5772/52737

Cardiorespiratory Complications During Sedation for Gastrointestinal Endoscopic Procedures

What is it about?

Gastrointestinal endoscopic (GIE) procedures are now performed routinely because of their minimal invasiveness and their diagnostic and therapeutic capabilities. These procedures have been shown to cause various effects on cardiorespiratory systems, which can increase the risks of the procedure in patients with underlying cardiorespiratory diseases. Additionally, the complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. Most predictors of cardiorespiratory-related complications are patient-centered factors and do not vary significantly from procedure to procedure although the procedure is complex.

Why is it important?

Although the serious adverse events are rare for the GIE procedural sedation. However, the cardiorespiratory-related complications are common. These complications may be severe if the physicians do not detect and treat the patients earlier. An adequate preprocedural history should be obtained and physical examination performed on all patients. Particular attention should be paid to the patient’s physical status and cardiorespiratory system.


Somchai Amornyotin
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University

Appropriate preprocedural assessment and optimization of the patients undergoing moderate or deep sedation are essential to minimize complications. Periodical assessment of the level of sedation and continuous monitoring of cardiovascular and respiratory systems provides timely information. Pulse oxymetry and oxygen supplementation are recommended for the reduction of hypoxemia. Capnography monitoring is considered in the patients undergoing prolonged endoscopic procedures who are at risk of deep sedation. Additionally, the standardized discharge criteria should be used to determine the patient’s readiness for discharge. Lastly, the physicians should remember that the risk for un-intended deeper level of sedation may be more common after the stimulation of the endoscopic procedure has been removed.

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The following have contributed to this page: Somchai Amornyotin