ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2020
Severity and duration of hypoxemia during outpatient endoscopy in obese patients: a retrospective cohort study.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 42 citations in OpenAlex.
- Combination of COMBO endoscopy oropharyngeal airway and high-flow nasal cannula oxygenation in sedated gastrointestinal endoscopy for morbidly obese patients: a Simon two-stage trial.BMC anesthesiology · 2026Trial
- Effect of supraglottic endotracheal tube inserted transorally on preventing hypoxemia in obese patients undergoing sedated bidirectional endoscopy: a prospective randomized controlled clinical trial.BMC anesthesiology · 2026Trial
- Dose-Finding of Alfentanil for Hysteroscopy Under Remimazolam Sedation in Obese and Normal-Weight Patients: An Up-and-Down Trial.Drug design, development and therapy · 2026Trial
- An Oxycodone-Based Conscious Analgesia Strategy with Supplemental Low-Dose Propofol Improves Safety in Elderly Obese Patients Undergoing Gastroscopy: A Prospective Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Comparison of the Effect of Different Administration Sequence of Propofol and Remifentanil on Sedation/Anesthesia During Gastroscopy in Obese Patients.Drug design, development and therapy · 2026Trial
- Oxygen reserve index monitoring reduced the incidence of low pulse oxygen saturation during deep sedation for hysteroscopy: a prospective randomized controlled trial.Frontiers in medicine · 2026Trial
- The effects of ciprofol and propofol on hypoxemia during gastrointestinal endoscopy in overweight and obese patients: a randomized controlled trial.BMC anesthesiology · 2025Trial
- Effect of transnasal humidified rapid-insufflation ventilatory exchange on the incidence of hypoxemia in sedated gastroscopy in children: a randomised controlled trial.BMC pediatrics · 2025Trial
- Effect of propofol sedation via a narrow-bore tube on hypoxemia risk during gastroscopy: a single-center, prospective, randomized controlled trial.BMC anesthesiology · 2025Trial
- Effect of high flow nasal cannula oxygenation on incidence of hypoxia during sedated gastrointestinal endoscopy in patients with obesity: multicentre randomised controlled trial.BMJ (Clinical research ed.) · 2025Trial
- Prospective Single-Arm Study of Remifentanil-Propofol Anesthesia with Manual Right Hypochondrial Compression for Painless Gastroscopy in Obese Patients.Drug design, development and therapy · 2025Trial
- Prospective evaluation of transoral outlet reduction (TORe) after Roux-en-Y gastric bypass (RYGB) failure.Surgical endoscopy · 2024Trial
- Anesthetic strategy for obese patients during gastroscopy: deep sedation or conscious sedation? A prospective randomized controlled trial.Journal of anesthesia · 2021Trial
- Effect of nasopharyngeal airway on hypoxemia in overweight and obese patients undergoing sedated endoscopy: A randomized trial.iScience · 2026Article
- Methodological Considerations Regarding Respiratory Safety and Recovery in Overweight or Obese Patients Undergoing Painless Gastroscopy.Drug design, development and therapy · 2026Article
- Article
- Current and Emerging Sedation Practices for Colonoscopy: A Narrative Review of Pharmacological Agents, High-Risk Populations, and Safety Considerations.Journal of clinical medicine · 2025Review
- Article
- Predictors of hypoxemia during moderate sedation for periodontal surgery: a series of 2,221 sedations.Journal of dental anesthesia and pain medicine · 2025Article
- Effects of ciprofol on respiratory-related adverse incidence in patients with obesity during painless gastroscopy: a prospective, randomized clinical trial.Perioperative medicine (London, England) · 2025Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe sought to quantify the severity and duration of hypoxemic events in morbidly obese patients during outpatient endoscopy procedures performed under deep sedation.
methodsThis was a retrospective cohort study using intraprocedural pulse oximetry readings from 11,595 American Society of Anesthesiologists physical status score I-III adult patients who underwent deep sedation for elective endoscopy at free standing ambulatory centres between June 2015 and June 2016. Unadjusted and risk-adjusted logistic regression analyses explored the relationship between increasing categories of body mass index (BMI) and intraoperative hypoxemia, severe hypoxemia, and prolonged hypoxemia.
resultsHypoxemia occurred in 600 (13%) patients with normal BMI, 314 (18%) with class I obesity, 159 (27%) with class II obesity, and 24 (19%) with class III obesity. Adjusted odds ratio (AOR) for any occurrence of intraoperative hypoxemia increased from 1.61 (95% confidence interval [CI], 1.35 to 1.90; P < 0.001) in the class I obesity group to 2.61 (95% CI, 2.05 to 3.30; P < 0.001) in patients with class II obesity, when compared with patients with normal BMI. Adjusted odds ratio of severe hypoxemia were significant in the class I obesity group (AOR, 1.47; 95% CI, 1.13 to 1.89; P = 0.003), and the class II obesity group (AOR, 2.59; 95% CI, 1.86 to 3.57; P < 0.001). Adjusted odds ratio of prolonged hypoxemia increased with each category of BMI from 1.97 (95% CI, 1.08 to 3.69) in the overweight group to 9.20 (95% CI, 4.74 to 18.03) in patients with class III obesity.
conclusionsThe incidence of severe hypoxemia increased nearly six-fold in obese patients and 8.5-fold in class III obese patients when compared with those of normal BMI. Intravenous fentanyl was associated with intraoperative hypoxemia independent of BMI. Patients who represent the highest risk for hypoxia should be stratified to procedure locations with adequate resources for the safest care.
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