Examination Of Respiratory And Circulatory Dynamics During Examination Using A Thin Gastrointestinal Endoscope In Advanced-Age Subjects

Background: Endoscopic examination influences cardiovascular hemodynamics. Upper gastrointestinal examinations are currently performed with a thin endoscope. In the present study, respiratory and circulatory dynamics and autonomic nervous activity using a thin endoscope (XP260) or a standard endoscope (XQ240) were investigated.Methods: The subjects were 25 healthy adults aged less than 60 years (middle-aged group) and 15 healthy adults aged 60 years or older (advanced-age group). Percutaneous oxygen saturation, tonometric blood pressure, heart rate, and autonomic nervous activity were evaluated before the examination. After the endoscopic procedure, a questionnaire survey regarding examination-related stress was conducted.Results: In the questionnaire survey, the proportion of subjects who answered 'very stress free' in the thin endoscope group was significantly higher than that in the standard endoscope group. The low frequency power of blood pressure variability (LFBP), an indicator of sympathetic nervous activity, was significantly lower during the thin endoscopic procedure than during the standard endoscopic procedure. Moreover, the ratio of low frequency power to high frequency power of heart rate variability (LFRR/HFRR), an indicator of sympathetic nervous activity, was significantly lower during thin endoscopic procedure than during the standard endoscopic procedure. The maximum rates of change in the LFRP and HFRR powers in the advanced-age group using thin and standard endoscopic procedures were significantly lower than in the middle-aged group.Conclusions: The findings, although not in cross-over study, suggest that a thin endoscope has a less marked influence on circulatory kinetics. Gastrointestinal endoscopic examinations using a thin endoscope might reduce complications related to endoscopic screening examinations in advanced-age subjects.