3329 The plasma propofol concentration during upper gasrointestinal endoscopy in young, middle-aged, and elderly patients.

Abstract

Background & Aims: Propofol is a short-acting, intravenous anesthetic , but elderly patients are more sensitive with this agent.We aimed to investigate the plasma propofol concentration required to induce and maintain safely adequate sedation in accordance with age of patients during gastroscopy. Methods: Any concentrations of propofol were administered by the target-controlled infusion under monitoring blood pressure, heart rate, and oxygen saturation. 10 minutes after the procedure started, arterial blood samples were drawn. Propofol concentrations were measured by high-performance liquid chromatography with fluorescence detection. The relation between sedation level and concentrations was assessed by a logistic regression analysis. Results: Higher plasma concentration was necessary to suppress somatic response to gastroscope insertion than that suppressed response to verbal command in young and middle-aged patients. In elderly patients, the concentration to suppress response to verbal command was sufficient to suppress somatic response. Systolic blood pressure (SBP) response upon insertion was decreased with increasing propofol concentration. The SBP response in elderly patients was higher than that in young and middle-aged patients. Conclusions: For a concentration to suppress somatic response, conscious sedation in a young patient was more difficult than that in an elderly patient. Background & Aims: Propofol is a short-acting, intravenous anesthetic , but elderly patients are more sensitive with this agent.We aimed to investigate the plasma propofol concentration required to induce and maintain safely adequate sedation in accordance with age of patients during gastroscopy. Methods: Any concentrations of propofol were administered by the target-controlled infusion under monitoring blood pressure, heart rate, and oxygen saturation. 10 minutes after the procedure started, arterial blood samples were drawn. Propofol concentrations were measured by high-performance liquid chromatography with fluorescence detection. The relation between sedation level and concentrations was assessed by a logistic regression analysis. Results: Higher plasma concentration was necessary to suppress somatic response to gastroscope insertion than that suppressed response to verbal command in young and middle-aged patients. In elderly patients, the concentration to suppress response to verbal command was sufficient to suppress somatic response. Systolic blood pressure (SBP) response upon insertion was decreased with increasing propofol concentration. The SBP response in elderly patients was higher than that in young and middle-aged patients. Conclusions: For a concentration to suppress somatic response, conscious sedation in a young patient was more difficult than that in an elderly patient.