Non-operating Room Anaesthesia Practices in an Endoscopy Unit at a Tertiary Centre: A Retrospective Evaluation

Abstract

Introduction:In recent years, gastrointestinal endoscopic procedures have been performed with sedo-analgesia at many centres. We aimed to present a 1-year retrospective analysis of non-operating room anaesthesia (NORA) applications at the endoscopy unit of our research and training hospital.Methods:We retrospectively analysed the NORA applications at our endoscopy unit between 01.01.2018 and 31.12.2018. The gender, age, American Society of Anaesthesiologist (ASA) score, intervention, anaesthesia drugs and complications were retrospectively analysed for 18.291 patients.Results:The sample comprised 47.03% men (n=8,602) and 52,97% women (n=9,689), with a mean age of 58.75±13.75 years (range, 16-92 years). Per the ASA classification, there were 57.22% (n=10,467), 37.92% (n=6,936), 4.79% (n=876) and 0.07% (n=12) patients with ASA grades I, II, III and IV, respectively. Gastroscopy (n=9,481, 51.84%), followed by colonoscopy (n=5,596, 30.60%) were the most commonly performed procedures. The combination of midazolam and meperidine; propofol, midazolam and meperidine and midazolam alone were administered for 43.99% (n=8,046); 53.48% (n=9,782) and 2.54% (n=463) of the patients, respectively. In a patient with hypertension, no major complication was encountered except for pneumothorax during the endoscopic retrograde cholangiopancreatography. The most common significant complication was desaturation; seen in 3.05% of the patients (n=559).Conclusion:Endoscopy units are non-operating units, albeit with a high patient volume. Thus, adopting sedation for interventional procedures in these units simplifies the procedure and increases patient safety and satisfaction, along with physician’s comfort. Compared with the studies performed at our clinic, we found similar complication rates as with sedoanalgesia protocols.

Keywords

• endoscopy unit
• non-operating room anaesthesia applications
• sedation