Capno cannula is useful for sedation management in patients undergoing esophagogastroduodenoscopy.

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 CO2. 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 CO2. 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 CO2 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 CO2 could be accurately measured in the perioperative period.

Figure 1

Capno cannula modified an oxygen supply tube and a carbon dioxide

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 CO2 in patients undergoing esophagogastroduodenoscopy.