Expert: JM Starkman, MD - 4/9/2010

Question
Hello Doctor, thank you for taking my question.  Two months ago, I underwent a upper endoscopy for evaluation of intestinal inflammation.  I am a 29-y.o. male, fairly healthy, and have had mac anesthesia twice before.  Things went well from what I had understood on the day of the procedure, went home ok, tired, and didn't remember much.  I didn't think twice about it, until recently I got the physician's report as part of records from the hospital.  I'm a little concerned that in the physician's notes, he stated:
"I was going to take biopsies at this time, although the patient began to desaturate and consequently the scope was withdrawn.  Although the patient was still breathing, he did require a short period of AMBU bagging until his saturations came up into the 90% level.  After that, it was felt safe to resume."
This alarmed me quite a bit when I read it on the report.  Nothing was even mentioned to me at all after, or since.  Can I ask what happened?  I'm sure I am paranoid about nothing - if it was something, they've of told me?  But could this have been caused by an underlying health problem?  I have been seeing a cardiologist of palpitations and I afraid maybe I have a heart condition that could have caused this?  He also stated that I "tolerated the procedure well".  Does this happen often, or could you explain the likely cause?  Thank you very much.

Answer
This is pretty common stuff during an upper endoscopy done under sedation and should certainly not be considered anything at all that should be given follow-up evaluation or therapy.  Anesthetics depress breathing and an endoscope sharing and occupying one's airway (mouth & throat) makes the anesthetic/upper endoscopy quite the tightrope-walk.  When oxygen levels fall too low, the scope is removed until oxygen levels return to normal either by spontaneous breathing or by assisting that breathing (ambu bag).  Nothing to worry about!  This IS necessarily the reason the procedure should be done with an anesthesiologist present (if that's not crazy obvious at this point......).