Key result
Narcotic premedication during upper gastrointestinal endoscopy caused a significant fall in PaO2 levels (20.3%-16.5%), which remained depressed except when using fentanyl and a pediatric instrument.
Why the study?
Does the choice of narcotic premedication and endoscope size affect arterial oxygen tension in elderly patients undergoing upper gastrointestinal endoscopy?
Observational (n=56)
Does the choice of narcotic premedication and endoscope size affect arterial oxygen tension in elderly patients undergoing upper gastrointestinal endoscopy?
To minimize hypoxemia in elderly patients during endoscopy, short-acting narcotics (or none) and pediatric instruments should be used.
Narcotic premedication linked to PaO2 decline during elderly endoscopy; leaves open whether fentanyl plus pediatric instruments mitigate risk in prospective trials.
Changes in arterial oxygen and carbon dioxide tensions were determined in 56 patients, mean age 67 years, during elective upper gastrointestinal endoscopy with standard or pediatric instruments. All the patients received intravenous atropine, diazepam, and either meperidine or fentanyl premedication. There was an immediate and significant fall in PaO2 levels (20.3%-16.5%) after both narcotic injections. The oxygen tension remained significantly depressed during the endoscopic examinations except in the group receiving fentanyl premedication and examined with the narrow pediatric instrument. To minimize hypoxemia in elderly patients during endoscopy, a short-acting narcotic or, preferably, no narcotic at all should be used in the premedication, and a narrow, pediatric instrument be used.
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Rozen et al. (1981) conducted an observational in Elective upper gastrointestinal endoscopy (n=56). Narcotic premedication (meperidine or fentanyl) and standard or pediatric instruments was evaluated on Changes in arterial oxygen and carbon dioxide tensions. Narcotic premedication during upper gastrointestinal endoscopy caused a significant fall in PaO2 levels (20.3%-16.5%), which remained depressed except when using fentanyl and a pediatric instrument.
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