Assessment of the Berlin Questionnaire for evaluation of hypoxemia risk in subjects undergoing deep sedation for screening gastrointestinal endoscopy

Figures & data

Table 1 Modified observer’s assessment of alertness/sedation scale

Response to external stimulus	Score
Agitated	6
Responds readily to name spoken in normal tone	5
Lethargic response to name spoken in normal tone	4
Responds only after name is called loudly and/or repeatedly	3
Responds only after mild prodding or shaking	2
Does not respond to mild prodding or shaking	1
Does not respond to painful stimulus	0

Table 2 Demographic, procedural, and sedation data of low-risk and high-risk groups

Variable	High risk (n=218)	Low risk (n=396)	P-value
Demographic data
Mean age ± SD, years	51.5 ± 10.8	49.0 ± 11.9	0.011
Sex, male, n (%)	164 (75.2)	183 (46.2)	<0.001
Mean height ± SD (cm)	165.9 ± 7.5	162.5 ± 8.8	<0.001
Mean weight ± SD (kg)	73.6 ± 10.6	60.0 ± 10.0	<0.001
Mean BMI ± SD (kg/m^2)	26.7 ± 2.8	22.6 ± 2.7	<0.001
HTN, n (%)	92 (42.2)	45 (11.4)	<0.001
DM, n (%)	24 (11.0)	16 (4.0)	0.001
ASA class			<0.001
I, n (%)	103 (47.2)	315 (79.5)
II, n (%)	115 (52.8)	81 (20.5)
Mallampati score			<0.001
I, n (%)	64 (29.4)	201 (50.8)
II, n (%)	119 (54.6)	185 (46.7)
III, n (%)	35 (16.0)	10 (2.5)
Procedure data
Mean EGD time ± SD, min	5.2 ± 1.3	5.3 ± 1.5	0.623
Mean colonoscopy time ± SD, min	13.6 ± 4.2	13.6 ± 4.3	0.989
Total endoscopy time ± SD, min	18.4 ± 4.3	19.1 ± 4.8	0.065
Sedation data
Mean TCI propofol concentration at the initial of EGD ± SD, µg/mL	3.0 ± 0.2	3.0 ± 0.3	0.176
Mean TCI propofol concentration at the end of EGD ± SD, µg/mL	3.0 ± 0.5	3.2 ± 0.5	<0.001
Mean TCI propofol concentration during colonoscopy ± SD, µg/mL	2.5 ± 0.3	2.6 ± 0.4	<0.001
Mean total propofol dose for EGD ± SD, mg	116.9 ± 24.3	99.5 ± 26.6	<0.001
Mean total propofol dose during colonoscopy ± SD, mg	48.2 ± 22.5	51.6 ± 30.0	0.109
Mean total propofol dose ± SD, mg	181.6 ± 35.4	164.4 ± 43.3	0.009
End-tidal CO2 during colonoscopy ± SD, mmHg	43.2 ± 6.4	41.1 ± 6.4	<0.001

Abbreviations: SD, standard deviation; BMI, body mass index; HTN, hypertension; DM, diabetes mellitus; ASA, American Society for Anesthesiology; EGD, esophagogastroduodenoscopy; TCI, target-controlled infusion.

Table 3 Comparison of incidence of hypoxemia and use of AMs between high-risk and low-risk OSA groups

Hypoxemia/AMs	High-risk group (n=218)	Low-risk group (n=396)	Relative risks (95% CI)
Hypoxemia
During EGD	34 (15.6%)	22 (5.6%)	2.81 (1.69–4.68)
During colonoscopy	29 (13.3%)	9 (2.3%)	5.86 (2.82–12.1)
During EGD and/or colonoscopy	54 (24.8%)	29 (7.3%)	3.38 (2.22–5.15)
AMs
During EGD	40 (18.3%)	30 (7.6%)	2.42 (1.55–3.78)
During colonoscopy	39 (17.9%)	12 (3.0%)	5.90 (3.16–11.0)
During EGD and/or colonoscopy	61 (28.0%)	37 (9.3%)	2.99 (2.06–4.35)

Abbreviations: AMs, airway maneuvers; EGD, esophagogastroduodenoscopy; OSA, obstructive sleep apnea.