Adverse events in patients with obstructive sleep apnea undergoing procedural sedation in ambulatory settings: An updated systematic review and meta-analysis.

Objective: Patients with obstructive sleep apnea (OSA) may be at increased risk for adverse events during procedural sedation, however, there remains a gap in the literature quantifying these risks. This systematic review and meta-analysis aimed to evaluate the risk of peri-procedural adverse events in OSA patients undergoing procedural sedation in ambulatory settings, compared to those without OSA.
Methods: Four databases were systematically searched for studies published from January 1, 2011 to January 4, 2024. The inclusion criteria were: adult patients with OSA undergoing procedural sedation in ambulatory settings, peri-procedural adverse events reported, and control group included. The primary outcome was the incidence of peri-procedural adverse events amongst patients with vs without OSA.
Results: Nineteen studies (27,973 patients) were included. The odds of respiratory adverse events were significantly increased for patients with OSA (OR 1.65, 95 % CI 1.03-2.66, P = 0.04). Furthermore, the odds of requiring an airway maneuver/intervention were significantly greater for patients with OSA (OR 3.28, 95 % CI 1.43-7.51, P = 0.005). The odds of cardiovascular adverse events were not significantly increased for patients with OSA.
Conclusion: Patients with OSA undergoing procedural sedation in ambulatory settings had 1.7-fold greater odds of respiratory adverse events and 3.3-fold greater odds of requiring airway maneuvers/interventions.
Competing Interests: Declaration of competing interest EY reports research support from the Canadian Institutes of Health Research (CIHR) Canada Graduate Scholarships Doctoral Award (funding reference number: FBD-195197). TJG has served as consultant for Haisco Phramaceutical USA. GPJ has received honoraria from Merck Sharpe Dohme, Vertex, and Haisco Phrama USA. Dr. FC reports research support from the Ontario Ministry of Health Innovation Grant, ResMed Foundation, consultant to Takeda and Haisco Pharma, and STOP-Bang Questionnaire proprietary to University Health Network. This research was supported by University Health Network Foundation and ResMed Foundation.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)