Present address: Crosshouse Hospital, Kilmarnock, Scotland.
Examination of cardiorespiratory changes during upper gastrointestinal endoscopy
Comparison of monitoring of arterial oxygen saturation, arterial pressure and the electrocardiogram
Article first published online: 22 FEB 2007
Volume 46, Issue 3, pages 181–184, March 1991
How to Cite
MURRAY, A. W., MORRAN, C. G., KENNY, G. N. C., MACFARLANE, P. and ANDERSON, J. R. (1991), Examination of cardiorespiratory changes during upper gastrointestinal endoscopy. Anaesthesia, 46: 181–184. doi: 10.1111/j.1365-2044.1991.tb09404.x
† Senior Registrar, Department of Anaesthetics, Royal Victoria Infirmary, Newcastle-upon-Tyne.
- Issue published online: 22 FEB 2007
- Article first published online: 22 FEB 2007
- Accepted 11 June 1990.
- gastrointestinal endoscopy;
- blood pressure;
- pulse oximetry
Critical events including hypoxaemia, arrhythmias and myocardial ischaemia may occur more frequently during endoscopic procedures than during anaesthesia. A study was undertaken to assess the cardiovascular changes and to evaluate suitable monitoring techniques to detect critical events during sedation and endoscopy. Twenty patients scheduled to undergo a prolonged endoscopic procedure which required deep sedation were studied. Continuous recordings of electrocardiogram, heart rate and arterial oxygen saturation were made and arterial pressure was recorded at one-minute intervals. The study commenced immediately before administration of sedatives, continued for the duration of the examination and for one hour following the examination. Oxygen saturation decreased in all patients during the examination to a mean of 82.9% (SD 11.9), and remained below baseline for the duration of the examination and into the recovery period. Statistically significant increases and reductions of systolic arterial pressure and rate-pressure product were found during the procedures compared with baseline values recorded before administration of sedatives. Sixteen of the 20 patients developed tachycardia during the examination. Ten patients developed ectopic foci which were supraventricular, ventricular or both in origin. Electrocardiogram changes resolved during the recovery period. Myocardial ischaemia was assessed by S-T segment depression and a significant correlation was found between S-T segment depression and hypoxaemia, although the magnitude of the S-T depression was small and may not have been detected clinically. No correlation was found between S-T segment depression and arterial pressure, heart rate or rate-pressure product. Regular and frequent assessments of arterial pressure and heart rate are desirable but the results confirm the importance of monitoring arterial oxygen saturation in addition to arterial pressure and the electrocardiogram.