Capnographic monitoring of ventilatory status during moderate (conscious) sedation

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Abstract
Background: Moderate (conscious) sedation is required to perform endoscopic procedures. Capnography provides a means for continuous, real-time monitoring of ventilation and may also decrease the incidence of oversedation. Methods: A retrospective examination of all endoscopic procedures performed from January through December 2001 at our institution was undertaken to determine the potential benefits of capnographic monitoring. Results: In 4,846 endoscopic procedures performed without capnography, adverse outcomes related to moderate sedation were noted in 14 cases (0.29%). A subset of patients at higher risk for moderate sedation was identified. There were no cases of oversedation in 600 cases monitored with capnography. The complication rates were not significantly different for the two groups (p = 0.30, NS). Conclusion: The addition of capnography during moderate sedation endoscopy does not appear to significantly lower anesthesia-related morbidity. However, in cases requiring moderate sedation for prolonged procedures, in older patients with comorbidities, or in instances where respiratory excursion of the patient is obscured from view, practitioners should nonetheless consider capnography.

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