Presented at the American Laryngological Association, Combined Otolaryngology Spring Meetings, Las Vegas, Nevada, U.S.A., April 28–29, 2010.
Article first published online: 22 OCT 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 11, pages 2231–2236, November 2010
How to Cite
Yung, K. C. and Courey, M. S. (2010), The Effect of office-based flexible endoscopic surgery on hemodynamic stability. The Laryngoscope, 120: 2231–2236. doi: 10.1002/lary.21135
The authors have no funding, financial relationships, or conflicts of interest to disclose.
This study was performed at the University of California, San Francisco.
- Issue published online: 22 OCT 2010
- Article first published online: 22 OCT 2010
- Manuscript Accepted: 1 JUL 2010
- Manuscript Revised: 29 JUN 2010
- Manuscript Received: 2 MAR 2010
- Office-based surgery;
- laryngeal surgery;
- transnasal esophagoscopy;
- Level of Evidence: 4
Because of technological advances in endoscopy equipment, office-based flexible endoscopic surgery (OBFES) is becoming more widespread and common in practice. In our experience, we have noticed that patients often have marked rises in heart rate (HR) and blood pressure (BP). However, to our knowledge, changes in hemodynamic stability during these procedures have never been studied. The primary aim of this study was to investigate changes in BP, HR, and oxygen (O2) saturation in patients undergoing unsedated laryngeal surgery.
Retrospective chart review.
Medical records for 31 consecutive subjects who underwent OBFES at the University of California, San Francisco Mt. Zion Endoscopy Suite from June 2008 to June 2009 were reviewed. Absolute values and changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, and O2 saturation from baseline were evaluated.
During the procedure, 9/31 patients had tachycardia (29%) and 7/31 had severe hypertension (23%). The mean change in HR was 14.6 beats/min (P < .0001), mean change in DBP was 18.5 mm of mercury (Hg) (P < .0001), mean change in SBP was 33.1 (P < .0001), and mean change in O2 was 0.8 (P = .01). Older age groups had significantly higher baseline DBP (P = .02) and SBP (P = .0006), as well as procedural SBP (P = .0007). One procedure was terminated early secondary to unsafe rises in SBP and DBP. Change in DBP and SBP was not correlated with age.
Significant changes in hemodynamic status occur during OBFES. Clinicians should be aware of this and consider the risks these changes may pose to their patients. Monitoring during these procedures may be indicated. Laryngoscope, 2010