Severe cardiorespiratory complications derived from propofol sedation monitored by an endoscopist

espanolIntroduccion: la sedacion profunda con propofol controlada por endoscopista en las diferentes unidades de endoscopia ha sido un tema de continua controversia a lo largo de los ultimos anos, origen de conflictos de intereses entre las distintas sociedades cientificas de Anestesiologia y Gastroenterologia. Numerosos estudios han demostrado ya la eficacia, eficiencia y escasa aparicion de complicaciones en la sedacion controlada por un endoscopista formado frente al anestesiologo. Material y metodos: hemos revisado en nuestra base de datos el porcentaje de complicaciones cardiorrespiratorias graves en nuestra unidad, en el periodo comprendido entre 2011 y 2016, en las distintas exploraciones endoscopicas que realizamos (gastroscopia, colonoscopia, colangiopancreatografia retrograda endoscopica [CPRE] y ecoendoscopia [USE]) y cuya sedacion es controlada por un endoscopista. Resultados: se llevo a cabo el analisis de 33.195 exploraciones durante el periodo de estudio. Obtuvimos un 0,13% de complicaciones cardiorrespiratorias, la mayor parte de ellas desaturaciones graves (la mayoria respondieron a la apertura de la via aerea asociada a la interrupcion de la infusion del farmaco, precisando la necesidad de ambu en contadas ocasiones). No existieron diferencias estadisticamente significativas entre los diferentes grupos excepto en edad media, riesgo por tipo de exploracion y riesgo ASA, donde la CPRE presento una p EnglishIntroduction: deep sedation with propofol monitored by an endoscopist in different endoscopy units is a controversial subject and the source of conflicts of interest between the various scientific societies of Anesthesiology and Gastroenterology. Many studies have already demonstrated the efficacy, efficiency and low incidence of complications associated with sedation when under the control of a trained endoscopist vs an anesthesiologist. Material and methods: the rate of severe cardiorespiratory complications during various endoscopic examinations (gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP] and endoscopic ultrasound [EUS]) where sedation was controlled by an endoscopist within our unit, from 2011 to 2016, was reviewed. Results: during the study period, 33,195 examinations were analyzed. The rate of cardiorespiratory complications was 0.13% and the majority were severe desaturations. Most cases responded to an opening in the airway associated with the interruption of drug infusion and an ambu bag was required in a few cases. There were no statistically significant differences between the different groups, except for mean age, risk by type of examination and ASA risk, where the difference between ERCP and the rest of examinations was statistically significant. Conclusion: there is a high level of evidence in the scientific literature suggesting that sedation controlled by a trained endoscopist is safe, effective and efficient. However, further prospective studies are required in order to confirm this conclusion due to the fact that the majority of studies to date are retrospective