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LETTER TO EDITOR
Year : 2015  |  Volume : 9  |  Issue : 2  |  Page : 233-234

Capno cannula is useful for sedation management in patients undergoing esophagogastroduodenoscopy


Department of Anesthesiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan

Correspondence Address:
Dr. Hironobu Ueshima
Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama - 350 1298
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.152904

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Date of Web Publication10-Mar-2015
 


How to cite this article:
Ueshima H, Kitamura A. Capno cannula is useful for sedation management in patients undergoing esophagogastroduodenoscopy. Saudi J Anaesth 2015;9:233-4

How to cite this URL:
Ueshima H, Kitamura A. Capno cannula is useful for sedation management in patients undergoing esophagogastroduodenoscopy. Saudi J Anaesth [serial online] 2015 [cited 2019 Dec 10];9:233-4. Available from: http://www.saudija.org/text.asp?2015/9/2/233/152904

Sir,

In 2002, the American Society of Anesthesiologist published the practice guidelines for nonanesthesiologists administrating sedation and analgesia. [1] Sedation has gained attention in the previous decade.

Nonanesthesiologists frequently perform sedation in the endoscopy suite. [2] The guidelines recommend administering oxygen via an oxygen mask in the endoscopy suite if there are no contraindications. [1] A plastic syringe needle is usually attached to a standard capnography line to routinely measure the end-tidal CO 2 . However, because the oxygen mask interferes with the endoscope, it cannot be placed while performing esophagogastroduodenoscopy; therefore, this method cannot be used to accurately measure end-tidal CO 2 . Thus, oxygen is administered via a nasal cannula. However, attaching a plastic syringe needle to a standard capnography line is difficult. Capno cannula (Galemed Corporation, Taiwan) modified an oxygen supply tube and a carbon dioxide [Figure 1]. Herein, we report two cases in which end-tidal CO 2 could be accurately measured using the capno cannula in the patients undergoing esophagogastroduodenoscopy. The first patient was a 55-year-old woman, and the second patient was a 47-year-old man. Both patients underwent esophagogastroduodenoscopy under sedation with mizazolam. They were supplied with the oxygen at a concentration of 3 L/min via a capno cannula. Moderate sedation was achieved, and end-tidal CO 2 could be accurately measured in the perioperative period.
Figure 1: Capno cannula modified an oxygen supply tube and a carbon dioxide

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Sedation for upper gastrointestinal endoscopy is generally considered as safe, with only minimal risk for the patients. However, cardiopulmonary complications may account for over 50% of all reported complication. [3] Furthermore, a survey by the American College of Gastroenterology physician members revealed that three-quarters of practitioners use an opioid combined with a benzodiazepine for sedation. [4] Therefore, we must close pay attention to some complications such as respiratory depression caused by some sedative drugs.

We believe that capno cannula would be useful for sedation management in and to accurate measure end-tidal CO 2 in patients undergoing esophagogastroduodenoscopy.

 
  References Top

1.
American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004-17.  Back to cited text no. 1
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2.
Seeff LC, Richards TB, Shapiro JA, Nadel MR, Manninen DL, Given LS, et al. How many endoscopies are performed for colorectal cancer screening? Results from CDC's survey of endoscopic capacity. Gastroenterology 2004;127:1670-7.  Back to cited text no. 2
    
3.
Arrowsmith JB, Gerstman BB, Fleischer DE, Benjamin SB. Results from the American Society for Gastrointestinal Endoscopy/U.S. Food and drug administration collaborative study on complication rates and drug use during gastrointestinal endoscopy. Gastrointest Endosc 1991;37:421-7.  Back to cited text no. 3
    
4.
Cohen LB, Wecsler JS, Gaetano JN, Benson AA, Miller KM, Durkalski V, et al. Endoscopic sedation in the United States: Results from a nationwide survey. Am J Gastroenterol 2006;101:967-74.  Back to cited text no. 4
    


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