Deep sedation for gastrointestinal endoscopy in elderly patients. Subgroup analysis

Abstract

Background: Gastrointestinal endoscopy is increasingly performed under sedation in older patients. Aging has implications in increasing the morbidity and the risk of complications related to sedation. The aim of this study is to assess the difference in complications between patients aged 65 to 74 years and those aged over 75 years.

Materials and methods: A prospective study was designed. Patients older than 65 years under deep sedation were included. Multivariate analysis was performed to assess complications in the propofol-sedated gastroscopy and propofol- and fentanyl-sedated colonoscopy groups.

Results: 1,225 sedations were performed and 97.3 % of endoscopic procedures were completed. Desaturation occurred in 121 patients (9.9 %) with no significant differences between the two groups, 71 patients in the 65-74 age group and 50 in the ≥75 age group (9.2 % vs 10.9 %; p = 0.336). Major complications requiring intervention occurred in 68 patients (5.6 %), 46 in the 65-74 age group and 22 in the ≥75 age group (6.0 % vs 4.8 %; p = 0.385). Age contributed to the development of complications in gastroscopy under propofol sedation.

Conclusions: Complications of gastrointestinal endoscopy under deep sedation in patients older than 65 years are mostly not serious. Deep sedation in patients aged 75 years and older is not associated with more complications than in patients aged 65 to 74 years.

Keywords: Deep sedation; Elderly; Gastrointestinal endoscopy; Sedation complications.