Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention

Fang, Hong; Zheng, Jinhai; Lai, Jingyi; Xia, Victor W.; He, Kaiping; Du, Debin

doi:10.1016/j.heliyon.2023.e13117

Cited by 1 publication

(3 citation statements)

References 29 publications

(30 reference statements)

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“…[7][8][9] In these patients, hypotension or hypertension resulting from general anesthesia can significantly increase the morbidity and mortality. 10 Both propofol and etomidate emulsion are non-ionic surfactants.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, ensuring hemodynamic stability becomes more important than achieving absolute target values for intraoperative blood pressure control 7–9 . In these patients, hypotension or hypertension resulting from general anesthesia can significantly increase the morbidity and mortality 10 …”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 , 9 In these patients, hypotension or hypertension resulting from general anesthesia can significantly increase the morbidity and mortality. 10 …”

Section: Introductionmentioning

confidence: 99%

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Sedation with a 1:1 mixture of etomidate and propofol for gastroscopy in hypertensive elderly patients

Liu

Huang

Wang

et al. 2023

J of Clinical Hypertension

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We hypothesized that the combined use of etomidate and propofol for endoscopic sedation in elderly hypertensive patients could reduce adverse reactions while providing ideal sedation. To validate our hypothesis, we conducted a prospective, randomized, controlled, double‐blinded study. A total of 360 elderly hypertensive patients scheduled for gastroscopy at our hospital were enrolled in the study, of whom 328 completed the trial. The patients were randomly assigned to one of three groups: the propofol group (group P), the etomidate group (group E), or the propofol‐etomidate combination group (mixed at a ratio of 1:1, group PE). We collected and analyzed the cardiopulmonary effects and side effects in each group. Regardless of the sedation drug used, the systolic blood pressure, mean blood pressure, and heart rate of involved patients were significantly affected. Oxygen desaturation and injection pain were more common in group P compared to groups E (33.6% vs. 14.8%, 31.8% vs. 2.7%, both P < 0.01) and group PE (33.6% vs. 13.6%, 31.8% vs. 6.4%, both P < 0.01). The incidence of myoclonus in the PE group was lower than that in the E group (10.9% vs. 61.2%, P < 0.01). Our results indeed demonstrated that the combined use of etomidate and propofol appeared to maintain cardiopulmonary stability with minimal side effects in older hypertensive patients scheduled for gastroscopy, which further implied that this sedation strategy could be a safe and pain‐free option for managing patients undergoing gastroscopy, particularly those at a higher risk of adverse cardiovascular events.

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