Rozen P, Oppenheim D, Ratan J, Laniado S, Gilat T
Scand J Gastroenterol. 1979;14(5):577-81. doi: 10.3109/00365527909181392.
Measurement of arterial oxygen tensions in elderly patients undergoing upper gastrointestinal endoscopy and in a matched control group undergoing colonoscopy showed a slight but significant fall in the PaO2 in both groups following premedication. The initial fall in PaO2 was probably due to the intravenous atropine, diazepam, and meperidine, mainly the latter. This fall of the oxygen tension continued in the gastroscopy group until the instrument was removed, while the controls rapidly returned to basal levels. This persistently reduced PaO2 in the former group is therefore most likely due to the physical presence of the endoscope in the pharynx. To minimize the occurrence of hypoxemia during gastroscopy, narcotics should probably not be used in the premedication of elderly patients. The procedure should be carried out after optimal oxygenation of the patient and be of short duration, and a narrow instrument may be useful in this group.
对接受上消化道内镜检查的老年患者以及接受结肠镜检查的匹配对照组进行动脉血氧张力测量，结果显示两组患者在术前用药后动脉血氧分压（PaO2）均出现轻微但显著的下降。PaO2的初始下降可能归因于静脉注射阿托品、地西泮和哌替啶，主要是后者。在胃镜检查组中，氧分压的下降持续到器械取出，而对照组则迅速恢复到基础水平。因此，前一组中持续降低的PaO2很可能是由于内镜在咽部的实际存在。为了尽量减少胃镜检查期间低氧血症的发生，老年患者术前用药可能不应使用麻醉剂。该操作应在患者充分氧合后进行，且持续时间要短，使用较细的器械可能对这组患者有用。
