SAFETY OF DEEP SEDATION WITH PROPOFOL IN PATIENTS ASA III

Aims To assess the safety of deep sedation with propofol controlled by the usual endoscopy team (doctor, nurse, assistant) in ambulant patients ASA III. – To analyse the risk factors for the occurrence of complications during deep sedation in these patients. – To assess the effect of the use of CPAP in patients with OSAS on the occurrence of complications.

Methods Observational cohort study. Consecutive patients undergoing non-complex outpatients gastroscopy, colonoscopy, and diagnostic echoendoscopy in which deep sedation is administered by the endoscopy team are included. Patients were divided into group 1 (ASA = III) and group 2 (ASA < III).

Results 562 patients are included, 80 (14.2%) group 1. Complications related to sedation were more frequent in group 1 (23.8% vs 14.5%; p = 0.05). Mainly desaturations (22.5% vs 0.6%; p = 0.03). There was no exitus, no need to finish the procedures or anesthesia intervention.

Complications was more frequent in men (18.8% vs 12.9%; p = 0.05), advanced age (median 65 vs 61 years; p < 0.01) and duration of the procedure (p 0.03).

In multivariate analysis, age with an OR 1.029 (95% CI; 1.009–1.107); p 0.02 and BMI with an OR 1.057 (95% CI; 1.009–1.107). There is no difference in the complications of OSAS patients with CPAP (31,3%) and without CPAP (18,8%) with a p value of 0.19.

Conclusions There are more complications in ASA 3 patients who are administered deep sedation with Propofol under the supervision of the endoscopy team. Respiratory complications appear to be more frequent in this group although there are no significant differences and they do not influence the need to discontinue the procedure. Age and BMI appear as risk factors independent of ASA classification of complications with Propofol sedation. In patients with OSAS, the use of CPAP does not appear to be significantly related to the occurrence of complications.