scholarly journals Dexmedetomidine is safe and reduces the additional dose of midazolam for sedation during endoscopic retrograde cholangiopancreatography in very elderly patients

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Osamu Inatomi ◽  
Takayuki Imai ◽  
Takehide Fujimoto ◽  
Kenichiro Takahashi ◽  
Yoshihiro Yokota ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Additional Dose ◽  
Very Elderly ◽  
Endoscopic Retrograde

Endoscopic Retrograde Cholangiopancreatography in Very Elderly Patients

2016 ◽  
Vol 111 ◽  
pp. S162
Author(s):  
Rikako Koyama ◽  
Tetsuo Tamura ◽  
Yuji Urasaki ◽  
Yuko Koizumi ◽  
Tsunao Imamura
Keyword(s):  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Very Elderly ◽  
Endoscopic Retrograde

Efficacy of an Oxycodone-Propofol Combination versus a Fentanyl-Propofol Combination in Conscious Sedation during Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients

Gerontology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Peipei Guo ◽  
Huisheng Wu ◽  
Lan Liu ◽  
Qiu Zhao ◽  
Zhao Jin
Keyword(s):  
Adverse Events ◽  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Conscious Sedation ◽  
Endoscopic Retrograde ◽  
Patients Satisfaction ◽  
Low Incidence

<b><i>Background:</i></b> With a rapidly aging population, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. The commonly used sedation anesthesia in ERCP is a combination of propofol and fentanyl, even though fentanyl may cause some adverse reactions such as respiratory depression. <b><i>Objectives:</i></b> This study aimed to evaluate the efficacy of oxycodone combined with propofol versus fentanyl combined with propofol for sedation anesthesia during ERCP. <b><i>Methods:</i></b> A total of 193 patients aged from 65 to 80 years undergoing ERCP were enrolled and randomized into two groups: an “oxycodone combined with propofol” group (group OP, <i>n</i> = 97) and a “fentanyl combined with propofol” group (group FP, <i>n</i> = 96). The rate of perioperative adverse events as well as the recovery time, patients’ satisfaction, and endoscopists’ satisfaction were noted. <b><i>Results:</i></b> There was no difference in the frequency of hypotension or bradycardia between the two groups, but there were more episodes of desaturation (SpO<sub>2</sub> &#x3c;90% for &#x3e;10 s in 8.3%), postoperative nausea (7.3%), and vomiting (5.2%) in group FP than in group OP. Patients’ satisfaction in group FP was lower than that in group OP. The recovery time was longer in group FP than in group OP. <b><i>Conclusions:</i></b> Oxycodone combined with propofol was effective in ERCP, with a low incidence of perioperative adverse events.

scholarly journals Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly

2020 ◽  
Vol 08 (09) ◽  
pp. E1202-E1211
Author(s):  
Ryunosuke Hakuta ◽  
Hirofumi Kogure ◽  
Yousuke Nakai ◽  
Tsuyoshi Hamada ◽  
Tatsuya Sato ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
The Elderly ◽  
Group Differences ◽  
Success Rates ◽  
Technical Success ◽  
Endoscopic Retrograde ◽  
Elderly Individuals ◽  
Technical Success Rate ◽  
Surgically Altered Anatomy

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy is challenging. Recently, balloon endoscopy has been shown to facilitate ERCP for this population with a high technical success rate, but adverse events (AEs) are not uncommon. Compared to non-elderly patients, elderly patients may be at higher risk of AEs due to underlying comorbidities. The current study aimed to evaluate the feasibility of balloon endoscope-assisted ERCP (BE-ERCP) for the elderly. Patients and methods We retrospectively identified patients who underwent BE-ERCP between January 2010 and September 2019. For patients who underwent multiple procedures during the study period, the first session was analyzed. Early AEs associated with BE-ERCP were compared between elderly (≥ 75 years) and non-elderly patients. Results A total of 1,363 BE-ERCP procedures were performed, and 568 patients (211 elderly and 357 non-elderly) were included for the analyses. Technical success rates were high in both the elderly and non-elderly groups (80 % vs. 80 %, respectively). The rates of early AEs were similar between the groups (12 % vs. 9.0 % in the elderly and non-elderly group, respectively; P = 0.31). The mltivariable-adjusted odds ratio for early AEs comparing elderly to non-elderly patients was 1.36 (95 % confidence interval, 0.74–2.51; P = 0.32). Specifically, we did not observe between-group differences in rates of gastrointestinal perforation (2.4 % vs. 2.8 % in elderly and non-elderly groups, respectively; P = 0.99) and aspiration pneumonia (1.9 % vs. 0.6 %, P = 0.20). Conclusions BE-ERCP is a feasible procedure for elderly individuals with surgically altered anatomy.

scholarly journals Electrocardiographic Changes in Elderly Patients During Endoscopic Retrograde Cholangiopancreatography

2003 ◽  
Vol 17 (9) ◽  
pp. 539-544 ◽  
Author(s):  
NG Kounis ◽  
GM Zavras ◽  
PJ Papadaki ◽  
SN Kouni ◽  
M Batsolaki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Myocardial Ischemia ◽  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Cardiac Arrhythmias ◽  
Holter Monitoring ◽  
Endoscopic Retrograde ◽  
St Segment ◽  
Ectopic Beats

BACKGROUND: Cardiorespiratory complications may occur during gastrointestinal endoscopy, and elderly people seem to be more vulnerable to these complications during endoscopic procedures involving the manipulation of abdominal viscera. OBJECTIVES: To determine the incidence of cardiac arrhythmias, changes in oxygen saturation, heart rate and blood pressure during endoscopic retrograde cholangiopancreatography (ERCP) via Holter monitoring in elderly patients older than 70 years of age.METHODS: Holter monitoring and 12-lead electrocardiograms were performed in 30 elderly patients undergoing ERCP and in 30 control subjects undergoing routine chest, abdomen, bone and upper gastrointestinal small bowel follow-through studies. A computerized nontriggered template system was used to analyze the electrocardiograms qualitatively and quantitatively. Arrhythmias, cardiac axis, conduction defects, pauses, ST segment changes, ectopic beats, oxygen desaturation and changes in blood pressure and rate-pressure product were evaluated.RESULTS: Increased heart rate, ST segment changes resulting from myocardial ischemia, oxygen desaturation and transient atrial and ventricular ectopic beats were frequent during ERCP compared with the control group. In one patient, transient left bundle branch block developed and this was attributed to pre-existing hypertension with cardiomegaly. One patient developed ventricular tachycardia and one other sinus bradycardia, but this was attributed to sick sinus syndrome.CONCLUSIONS: Transient myocardial ischemia and various cardiac arrhythmias are frequent in elderly patients undergoing ERCP. Appropriate noninvasive monitoring seems to be justified during this procedure.

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