CARDIOVASCULAR-RESPONSES, ARTERIAL OXYGEN-SATURATION AND PLASMA-CATECHOLAMINE CONCENTRATION DURING UPPER GASTROINTESTINAL ENDOSCOPY USING CONSCIOUS SEDATION WITH MIDAZOLAM OR PROPOFOL

Hypoventilation as a consequence of deep intravenous sedation is the m ost frequently reported cause of cardiac arrest during upper gastroint estinal endoscopy (UGIE). Haemodynamic stress can contribute to myocar dial ischaemia; therefore, this study was designed to observe prospect ively the cardiorespiratory changes during UGIE using either midazolam or propofol for conscious sedation. Thirty four patients, aged 50 yea rs and older, ASA physical status I-III, scheduled for elective UGIE w ith sedation, were studied. Oxygen saturation, heart rate, non-invasiv e blood pressure and Holter ECG were recorded continuously starting 15 min before sedation until 15 min after the endoscopy. in addition, pl asma catecholamine concentrations were determined. The results of this study are consistent with previous reports that cardiopulmonary event s may occur during endoscopy, with or without sedation. Both midazolam and propofol sedation may provide some protection against haemodynami c stress in response to insertion and manipulation of the endoscope, b ut sedation can also contribute to the occurrence of hypoxaemia.