# Optimal sedation/anesthesia practices for painless gastroscopy in older adults: a randomized trial

## TL;DR

This study explores the best sedation levels for painless gastroscopy in older adults, finding that deeper sedation and anesthesia work better.

## Contribution

The study provides new evidence on optimal sedation depth for painless gastroscopy in older adults.

## Key findings

- Groups with deep sedation and anesthesia had lower failure rates for gastroscope insertion.
- Bucking and body movement were significantly reduced in deeper sedation groups.
- Heart rate and blood pressure changes were more stable in deeper sedation groups.

## Abstract

The aim of this study is to conduct a preliminary exploration of the optimal sedation depth for painless gastroscopy in older adults.

Sixty older adults who underwent painless gastroscopy in April 2023 at Northern Jiangsu People’s Hospital, Jiangsu Province, were included in the study and randomly assigned to four groups: minimal sedation (Group I), moderate sedation (Group II), deep sedation (Group III), and anesthesia (Group IV). Data were collected on sedation depth after induction and titration (T1), swallowing response during gastroscope insertion (T2), and bucking during the procedure (T3).

Following T1, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) showed a significant decrease, with change rates being notably higher in groups III and IV compared to groups I and II (P < 0.05). The failure rate of gastroscope insertion was significantly higher in groups I and II than in groups III and IV (P < 0.05). At T2, bucking and body movement scores were substantially lower in groups III and IV than in groups I and II (P < 0.05). After T2, the heart rate (HR) change rates in groups III and IV were significantly lower than in groups I and II (P < 0.05). Additionally, SBP and DBP were further reduced, with change rates being markedly higher in groups III and IV compared to groups I and II (P < 0.05). At T3, the incidence of bucking and body movements was significantly lower in groups II, III, and IV than in group I (P < 0.05).

Deep sedation and anesthesia are more suitable for older adults undergoing painless gastroscopy in terms of sedation depth.

https://www.chictr.org.cn/showproj.html?proj=191819, ChiCTR2300069999.