Anesthesia-Related Adverse Event Rate and Alteration of Blood Pressure and Heart Rate During and Immediately after Unsedated Esophagogastroduodenoscopy in Elderly Patients

Abstract

AIMS: Esophagogastroduodenoscopy (EGD) is safely performed by using topical pharyngeal anesthesia in elderly patients. However, it can induce hemodynamic changes and adverse events. The aim of this study was to compare and evaluate the anesthesia-related adverse event rate and the alteration of blood pressure and heart rate in unsedated EGD procedure between elderly patients and younger patients. METHODS: 1,998 patients underwent unsedated EGD procedures in the study period. All patients who had no history of hypertension, diabetes and cardiovascular diseases were categorized into the two groups. Patients aged <65 years were in group A, and patients aged ≥65 years were in group B. The primary outcome variable was the anesthesia-related adverse event rate during and immediately after the procedure. The secondary outcome variables were the alteration of blood pressure and heart rate. RESULTS: After matching gender, weight, ASA physical status and indications of procedure, there were 342 patients in group A and 195 patients in group B. All endoscopies were completely successfully. There were no significant differences in gender, weight, ASA physical status, duration of procedure, indication of endoscopy, hemodynamic parameters, and the anesthesia-related adverse events between the two groups. All adverse events were mild degree, transient and did not require medications. CONCLUSION: Anesthesia-related adverse event rate and alterations of blood pressure and heart rate during and immediately after unsedated EGD procedure in the elderly patients are relatively high. However, all of these are mild, transient and did not greater than in the younger patients.