ABSTRACT
Three groups of patients with different premedications were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acid levels during esophago-gastro-duodenoscopy: Group A was premedicated with Bunitrolol, group B was premedicated with Hyoscin-N-butyl-bromide and diazepam, group C was endoscopied without premedication. The pulse rate rose significantly less in group A than in groups A and C; the same phenomenon was observed with regard to the systolic blood pressure. Premature beats occurred in all 3 groups: 32 per cent of the patients in group A, 43 per cent in group B and 60 per cent in group C had at least occasional premature beats; an accumulation of premature beats however occurred significantly less frequently in group A than in groups B or C. A drop of the ST-part of the ECG occurred with about the same frequency in each group. An increase of the plasma free fatty acids, which was noted in groups B and C, could be observed in Group A. A pre-endoscopic medication of beta blocking agents could be a useful measure in patients with labile arterial hypertension, vegatative dysregulation and a hyperkinetic heart syndrome.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Fatty Acids, Nonesterified/blood , Hemodynamics/drug effects , Adult , Aged , Blood Pressure/drug effects , Diazepam/therapeutic use , Endoscopy/methods , Heart Rate/drug effects , Humans , Middle Aged , Premedication , Propanolamines/therapeutic useABSTRACT
The colorectal cancers in greater part grow out of polyps, which can be looked upon as optional precancerosis. Own results together with literature-reports show a distinct increase of the frequency of polyps beyond the age of fortyfive. The only digital palpation of the rectum is insufficient; it leads to the diagnosis of a rectum polyp only in 15.5%, to the diagnosis of a cancer in 13% of cases. With the rectosigmoidoscopy however the diagnosis is successful in 70% of cases. The percentage of precancerous polypous alterations detected by rectosigmoidoscopy is approximately the same in medical check-up as in directed examinations of patients with anorectal discomfort. A restriction of rectosigmoidoscopy to the last-named group of persons is not any longer justified. The polypectomy in the rectum is a real cancer-prevention.
Subject(s)
Adenocarcinoma/diagnosis , Colonic Neoplasms/diagnosis , Intestinal Polyps/diagnosis , Rectal Neoplasms/diagnosis , Adult , Aged , Female , Humans , Male , Middle Aged , SigmoidoscopyABSTRACT
53 patients were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acids during esophago-gastro-duodenoscopy. In 23 cases there were premature contractions, occuring in small numbers only in most of the cases. Only in 5 cases there was an accumulation of premature contractions and in one case ventricular bigeminism occurred. The maximum of premature beats was observed when the primarily sitting patient was put into supine position. In 7 patients there was a lowering of the ST-segment in the ECG by at least 0.1 mV, mostly in patients who already had an abnormal ST-segment before endoscopy. The pulse rate went up by an average of 50.1 per cent, the systolic blood pressure by 14 and the diastolic blood pressure by 17 per cent. The increase of plasma free fatty acids in the total patient material was not statistically significant, but patients with a deterioration of ECG-findings endoscopy had a significantly higher increase of plasma free fatty acids. There was a tendency towards a positive correlation between the number of premature beats and the increase of plasma free fatty acids. It cannot be decided from our study whether the mobilization of free fatty acids is causing the above observed increase of premature beats or whether both phenomena are merely a result of sympathetic nervous stimulation. Gastric fiberoscopy may be applied to elderly patients with decreased cardiac function. The endoscopic procedure should not be started on the sitting patient but primarily in left supine position.
