A large endoscopy analysis associated multi-drug sedation with adverse events, while emphasizing that patient and procedural factors also mattered.
The investigators analyzed 23,788 adult endoscopies. At least one adverse event occurred in 7.55%. Their count model associated adding benzodiazepines to propofol with more events than propofol alone. Age, body mass index, clinical status, airway assessment, urgency, and procedure duration also contributed.
This was observational clinical data rather than random assignment of drug combinations. The study grouped events into broad categories and did not fully distinguish each procedure’s characteristics. A modeled increase in event counts is not the same as an individual absolute risk increase.
For a sedation opinion, consider the complete drug combination and the reasons it was selected. A benzodiazepine cannot be evaluated in isolation from opioids, propofol, airway vulnerability, and procedure duration. The study supports multivariable review without establishing which component caused a particular complication.
Source reviewed: Risk of adverse events in gastrointestinal endoscopy Zero inflated Poisson regression mixture model (PMC8245123). This article summarizes the supplied paper; forensic applications above are interpretive analysis.
Related reading: Special-Needs Dental Sedation Had Few Adverse Events and Nonrandom Regimen Selection; Japanese Hypnotic-Dependence Survey Linked Symptom Burden With Number of Medicines.