Katsube Takao, Kon-No Soichi, Hamaguchi Kanako, Shimakawa Takeshi, Naritaka Yoshihiko, Yagawa Hirokazu, Ogawa Kenji
Department of Surgery, Tokyo Women's Medical University Daini Hospital, Tokyo, Japan.
Hepatogastroenterology. 2005 Sep-Oct;52(65):1463-6.
BACKGROUND/AIMS: We measured changes in cardiopulmonary function of elderly patients during upper gastrointestinal endoscopy to examine the effects of antispasmodics.
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.
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.
Scopolamine butylbromide should be administered with caution in upper gastrointestinal endoscopy of elderly patients because it may increase cardiac load.
背景/目的：我们测量了老年患者在上消化道内镜检查期间心肺功能的变化，以研究解痉药的作用。
本研究对174名60岁以上的受试者进行（101名男性和73名女性，平均年龄71.0岁）。根据用于术前用药的解痉药，将受试者分为3组：76人接受重组胰高血糖素（G组）；63人接受丁溴东莨菪碱（B组）；35人未使用解痉药（N组）。在获得知情同意后，使用脉搏血氧仪在内镜检查过程中的五个时间点测量心率和血氧饱和度。
当内镜通过食管-贲门交界处时，所有组的心率均出现最大幅度升高，血氧饱和度均出现下降。在给予解痉药后，B组的心率显著高于G组或N组。
在老年患者的上消化道内镜检查中，丁溴东莨菪碱应谨慎使用，因为它可能会增加心脏负荷。
