Clinical use of the STOP-BANG questionnaire in patients undergoing sedation for endoscopic procedures.

E is relatively safe, with a complication rate of less than 1% for standard procedures such as esophagogastroduodenoscopy (EGD) and colonoscopy.1 Theoretically obstructive sleep apnea (OSA) can lead to cardiopulmonary complications during procedural sedation. However the initial studies addressing the presence of OSA in patients undergoing upper endoscopy and colonoscopy did not find an increased risk of cardiopulmonary complications.2, 3 The STOP-BANG questionnaire represents a highly sensitive tool particularly useful to screen patients with severe OSA.4 A positive score, defined as ≥3, has correlated with a higher rate of postoperative complications.5 The aim of this study was to evaluate the risk of OSA using a bedside screening instrument and determine if patients at high risk of OSA undergoing routine endoscopic procedures are more likely to become hypoxic during deep sedation. Institutional review board approval was obtained for this study.We performed a prospective cohort study of patients undergoing deep sedation for endoscopic procedures in the endoscopy unit at “GB Morgagni-L. Pierantoni” Hospital in Forlì, Italy. Our routine practice is to sedate patients using propofol alone or in combination with low dose opiate and/or benzodiazepine. Depth of sedation was assessed using the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score. Consecutive patients were enrolled between January 2010 and December 2010. By using a STOP-BANG score of 3 or higher for high risk, patients were dichotomized into high risk (HR) and low risk (LR) for OSA groups. Demographic, procedural, and pharmacologic characteristics were compared between groups using the chi-square test for dichotomous variables and unpaired t testing or the Mann-Whitney test for continuous variables. During the study period, 271 patients were enrolled, including 59 (22%) patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), 56 (21%) EGD, 93 (34%) colonoscopy and 63 (23%) Clinical use of the STOP-BANG questionnaire in patients undergoing sedation for endoscopic procedures