[Gastroscopy in advanced age: premedication, cardiac arrhythmias].
40 not selected elderly patients (average age 79.3 years were investigated with a oesophago-gastro-duodenoscopy (OGD). For premedication the patients got 5 mg Diazemuls R and 20 mg Buscopan R i.v. With 30 patients there was taken a blood-gas-analysis before premedication and before fiberendoscopy. ECG-registration was performed before OGD und during OGD with all patients. The premedication led to a reduction of the p02 on an average of 8.9%. The average pO2 did not decrease below the age-related value. In some cases there was a great difference. With a 86-year old woman the pO2 decreased about 25% after premedication and led to a severe hypoxaemiae. Only patients (12.5%) showed a few ventricular extrasystoles, there was no serious arrhythmia. After premedication the heart-rate rose over 100 heart-beats per minute up to maximal 137 beats/minute in 9 patients. If a low dose of Diazemuls R is used, there is no need to do the OGD in elderly patients without premedication. However, there should be the possibility to give a patient oxygen via nasal insufflation to prevent severe hypoxaemia which can occur in some cases. In general, monitoring is only necessary for patients with a higher risk.
Moser
B
B
Fachkrankenhaus für Innere Medizin, Marienkrankenhaus Nassau.
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage; D002245:Carbon Dioxide / Q000097:blood; D003975:Diazepam / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood; D011292:Premedication / Q000379:methods*; D011660:Pulmonary Heart Disease / Q000150:complications; D012307:Risk Factors
D002245:Carbon Dioxide; D002086:Butylscopolammonium Bromide; D003975:Diazepam; D010100:Oxygen
Gastroskopie im höheren Lebensalter: Prämedikation, Herzrhythmusstörungen.