Introduction
overdose, airway obstruction, hypoxemia, respiratory disorder, respiratory depression
AIRWAY OBSTRUCTION, HEMODYNAMIC INSTABILITY, RESPIRATORY DISORDER, EVENTS, RESPIRATORY DEPRESSION
The upper interventional endoscopy procedures of endoscopic submucosal dissection (ESD), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and double-balloon enteroscopy (DBE) are currently performed under sedation with sedative agents, including propofol, dexmedetomidine, and benzodiazepine, and analgesics, including fentanyl, pentazocine, and pethidine, to reduce patient distress and achieve successful completion. However, hypoxemia associated with respiratory depression or hemodynamic instability is well known to occur frequently during sedation. Furthermore, cardiopulmonary events during endoscopy are described to be the most important fatal complicationsThe European Society of Gastrointestinal Endoscopy recommended that capnography be considered during the administration of propofol in specific situations, including high-risk patients, intended deep sedation, and long procedure durationA nasal pressure monitor is a simple and easy-to-use tool for assessing airflow and is commonly used during polysomnography, whereas a pneumotachograph, the gold standard method for measuring airflow, is inconvenient for use in daily clinical practice due to the requirement for a well-fitting maskFor these reasons, a nasal pressure monitor can distinguish between the central respiratory disorder due to drug overdose and the airway obstruction that requires management by its waveform