Scopolamine raises cardiac demand in the elderly during gastrointestinal endoscopy.
OBJECTIVE
We measured changes in cardiopulmonary function of elderly patients during upper gastrointestinal endoscopy to examine the effects of antispasmodics.


METHODS
This study was conducted on 174 subjects older than 60 years (101 male and 73 female, mean age 71.0). Subjects were divided into 3 groups based on the antispasmodic used for pre-medication: 76 received recombinant glucagon (Group G); 63 scopolamine butylbromide (group B); and 35 had no antispasmodic (group N). After informed consent a pulse oximeter was used to measure heart rate and oxygen saturation at five points during the endoscopic procedure.


RESULTS
Maximum heart rate increase and oxygen saturation decrease occurred in all groups when the endoscope passed through the esophago-cardiacjunction. Heart rate was significantly higher in group B than G or N after administration of antispasmodic drugs.


CONCLUSIONS
Scopolamine butylbromide should be administered with caution in upper gastrointestinal endoscopy of elderly patients because it may increase cardiac load.
Katsube
Takao
T
Department of Surgery, Tokyo Women's Medical University Daini Hospital, Tokyo, Japan.
Kon-No
Soichi
S
Hamaguchi
Kanako
K
Shimakawa
Takeshi
T
Naritaka
Yoshihiko
Y
Yagawa
Hirokazu
H
Ogawa
Kenji
K
D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000494:pharmacology*; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D012601:Scopolamine / Q000494:pharmacology*
D018727:Muscarinic Antagonists; D012601:Scopolamine; D010100:Oxygen