Document Detail


The Effect of office-based flexible endoscopic surgery on hemodynamic stability.
MedLine Citation:
PMID:  20938961     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: Because of technological advances in endoscopy equipment, office-based flexible endoscopic surgery (OBFES) is becoming more widespread and common in practice. In our experience, we have noticed that patients often have marked rises in heart rate (HR) and blood pressure (BP). However, to our knowledge, changes in hemodynamic stability during these procedures have never been studied. The primary aim of this study was to investigate changes in BP, HR, and oxygen (O(2)) saturation in patients undergoing unsedated laryngeal surgery.
STUDY DESIGN: Retrospective chart review.
METHODS: Medical records for 31 consecutive subjects who underwent OBFES at the University of California, San Francisco Mt. Zion Endoscopy Suite from June 2008 to June 2009 were reviewed. Absolute values and changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, and O(2) saturation from baseline were evaluated.
RESULTS: During the procedure, 9/31 patients had tachycardia (29%) and 7/31 had severe hypertension (23%). The mean change in HR was 14.6 beats/min (P < .0001), mean change in DBP was 18.5 mm of mercury (Hg) (P < .0001), mean change in SBP was 33.1 (P < .0001), and mean change in O(2) was 0.8 (P = .01). Older age groups had significantly higher baseline DBP (P = .02) and SBP (P = .0006), as well as procedural SBP (P = .0007). One procedure was terminated early secondary to unsafe rises in SBP and DBP. Change in DBP and SBP was not correlated with age.
CONCLUSIONS: Significant changes in hemodynamic status occur during OBFES. Clinicians should be aware of this and consider the risks these changes may pose to their patients. Monitoring during these procedures may be indicated.
Authors:
Katherine C Yung; Mark S Courey
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2231-6     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA. kyung@ohns.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Ambulatory Surgical Procedures / adverse effects*,  methods
Blood Pressure Determination
Cohort Studies
Female
Follow-Up Studies
Gastroesophageal Reflux / diagnosis,  surgery
Heart Rate
Hemodynamics / physiology*
Humans
Laryngeal Diseases / diagnosis,  surgery*
Laryngeal Neoplasms / diagnosis,  surgery
Laryngoscopes*
Laryngoscopy / methods*
Male
Middle Aged
Oxygen Consumption
Postoperative Complications / physiopathology
Retrospective Studies
Risk Assessment
Vocal Cord Paralysis / diagnosis,  surgery
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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