| Theme |
Optimal Sedation in Gastrointestinal Endoscopy : Understanding and Using the New Guidelines Correctly |
| Title |
Anesthesia Method for Endoscopic Procedures in Elderly Patients |
| Author |
Naoko Yagi |
Department of Gastroenterology, Tokyo Medical University Hospital |
| Author |
Takuji Gotoda |
Department of Gastroenterology, Tokyo Medical University Hospital |
| Author |
Sho Suzuki |
Department of Gastroenterology, Tokyo Medical University Hospital |
| Author |
Shin Kono |
Department of Gastroenterology, Tokyo Medical University Hospital |
| Author |
Kunio Iwatsuka |
Department of Gastroenterology, Tokyo Medical University Hospital |
| Author |
Fuminori Moriyasu |
Department of Gastroenterology, Tokyo Medical University Hospital |
| [ Summary ] |
Chronic diseases frequently occur in elderly patients due to age‒associated functional decline of organs. These conditions, coupled with a low compensatory function against stress, increases the risk associated with the administration of sedatives in comparison with that in younger patients. Therefore, during endoscopic examination of elderly patients under sedation, it is critical to understand the procedural accidents that may occur as a result of circulatory and respiratory depression. Circulatory depression may cause reduced blood pressure, bradycardia, and arrhythmia, while respiratory depression may result in upper airway occlusion, reduced oxygen saturation, and respiratory arrest. Since many elderly patients have chronic underlying diseases, and are prone to procedural accidents, a detailed patient interview should be conducted prior to the procedure. Elderly patients should be initially administered a reduced dose of sedatives. After this initial dose, the decision to administer an additional dose should be carefully considered based on the monitoring and direct observation of the patient's condition, in order to determine the sedative's efficacy. |