Rozen P, Fireman Z, Gilat T
Scand J Gastroenterol. 1981;16(2):299-303. doi: 10.3109/00365528109181972.
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.
对56名平均年龄67岁的患者，在使用标准或儿童器械进行选择性上消化道内镜检查期间，测定动脉血氧和二氧化碳分压的变化。所有患者均接受静脉注射阿托品、地西泮，并在术前使用哌替啶或芬太尼。两次注射麻醉剂后，动脉血氧分压水平立即显著下降（从20.3%降至16.5%）。在内镜检查期间，除了接受芬太尼术前用药并使用狭窄儿童器械检查的组外，氧分压仍显著降低。为尽量减少老年患者在内镜检查期间的低氧血症，术前用药应使用短效麻醉剂，或者最好根本不使用麻醉剂，并使用狭窄的儿童器械。
