Incidence and Risk Factors of Significant Unplanned Events During Anaesthesia-Assisted Gastrointestinal Endoscopy: A Prospective Observational Study

Introduction: Gastrointestinal (GI) endoscopy is essential for managing various GI conditions, particularly in critically ill patients. These procedures, often performed under anaesthesia, carry risks of significant unplanned events (SUEs), which can impact patient safety. This study assessed the incidence and risk factors of SUEs during anaesthesia-assisted GI endoscopy. Materials and Methods: A prospective observational study was conducted in a tertiary care center involving 170 adult patients undergoing elective or emergency GI endoscopy under anaesthesia. Demographic, clinical, and procedural data were collected using standardized forms. SUEs included airway obstruction, hypoxia, hypotension, bradycardia, and cardiac arrest. Statistical analyses were performed using SPSS v23 with p<0.05 as the threshold for significance. Results: Of 170 patients, 54.7% were male; the mean age was 43.3±16.7 years. Most were ASA Grade I or II. TIVA was the most common anaesthetic technique (57.6%). The overall SUE incidence was 9%, with hypoxia and hypotension each in 2.4%, bradycardia and airway obstruction in 1.8%, and cardiac arrest in 0.6%. Higher ASA grades, poor general condition, and CNS or respiratory findings were associated with more events. Conclusion: Though generally safe, GI endoscopy under anaesthesia can result in SUEs. Comprehensive monitoring, risk assessment, and standardised protocols are crucial to enhancing patient safety and outcomes.