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PubMed · 2049361

Changes in oxygen saturation using two different sedation techniques.

G M Walton·C A Boyle·P J Thomson
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Abstract

Pulse oximetry was used to assess the degree of hypoxia observed in patients receiving simple midazolam sedation for removal of lower third molars and compared to that seen in patients receiving a combination sedation technique using nalbuphine and midazolam. Results showed that the degree of hypoxia experienced by patients receiving the combination technique was significantly more profound in both incidence and depth than that seen in the group receiving midazolam alone (p less than 0.05).

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Procedural SedationDrug CombinationsHumansHypoxiaMidazolamNalbuphineOximetryOxygenOxygen ConsumptionClinical TrialControlled Clinical TrialJournal ArticleRandomized Controlled Trial

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G M Walton, C A Boyle, P J Thomson. 1991. Changes in oxygen saturation using two different sedation techniques.. https://doi.org/10.1016/0266-4356(91)90087-l

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Asleep on the job: sedation and monitoring during endoscopy.

Gastrointestinal endoscopic procedures are invasive and carry a significant morbidity and mortality, even for diagnostic procedures (mortality of 1 in 2000 for upper gastrointestinal endoscopy). The commonest causes of death are cardiopulmonary complications, which may in part be related to sedative techniques. The clinical end-points for sedation need to be reappraised and should aim to induce amnesia rather than hypnosis. Endoscopists need to be familiar with the pharmacokinetic and pharmacodynamic properties of the benzodiazepines used for sedation. This applies particularly to the protracted half-lives of some benzodiazepines and the major drug interaction with significant synergy that occurs if opioids are used in combination with benzodiazepines. Thus appropriate doses of these drugs should be administered. The use of supplemental oxygen and pulse oximetry, combined with continuous intravenous access during the procedure should be standard practice. Endoscopists should be aware of national guidelines for safe endoscopic practice.

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