Complication Rate of Propofol-Based Deep Sedation for Colonoscopy in Marked Obesity Patients

Abstract

AIM: To evaluate and compare the complication rate of propofol-based deep sedation (PBDS) for colonoscopy in marked obesity (BMI > 30) and non-obesity (BMI < 25) patients in a teaching hospital in Thailand.

METHODS: We undertook a retrospective review of the sedation service records of adult patients who underwent colonoscopic procedures from December 2009 to April 2011. All patients were classified into two groups according to the body mass index (BMI). In group A, the patients had BMI < 25. In group B, the patients had BMI > 30. The primary outcome variable was the overall complication rate. The secondary outcome variables were sedation and procedure-related complications during and immediately after the procedure.

RESULTS: After matching age, gender, ASA physical status, sedation time and indications of procedure, there were 100 colonoscopic procedures in group A and 33 colonoscopic procedures in group B. All sedation was given by residents or anesthetic nurses directly supervised by staff anesthesiologist in the endoscopy room. There were no significant differences in patients’ characteristics, sedation time, indication of procedure, overall complication rate, anesthetic personnel and mortality rate between the two groups. However, upper airway obstruction in group B was relatively higher than in group A. All complications were easily treated, with no adverse sequelae.

CONCLUSION: PBDS for colonoscopic procedure in marked obesity patients by trained anesthetic personnel with appropriate monitoring was relatively safe and effective. The complication rate of this technique in marked obesity (BMI > 30) patients was not different or worse than in non-obesity (BMI < 25) patients. Serious complications were rare in our population.