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There are some patients, predominantly alcoholics, who show little response to the usual premedication with narcotics, anticholinergics, barbiturates, tranquilizers, or neuroleptic analgesics; in older patients, these medications can cause transient respiratory arrest, loss of consciousness, or acute coronary insufficiency. Rigid dose schedules must be avoided at all costs; older patients frequently tolerate the examination without any premedication better than adolescents. In three-fourths of all patients, according to a study from Norway , an identical effect can be obtained with intravenous administration of normal saline.
3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. gas to clarify the question of inert gas insufflation in electrosurgical endoscopy. Endoscopy 8, 133 (1976) GREENE, W. , YOUNG, V. , WIERNIK, P. : Esophagoscopy as a source of pseudomonas aeruginosa sepsis in patients with acute leukemia: the need for sterilization of endoscopes. : Nil nocere! Zwischenfalle bei der Saugbiopsie des Magens. MUnch. Med. Wochenschr. 45,2642 (1968) JACOBSOHN, W. : Colonoscopic perforation: its emergency treatment. : Das Risiko der perkutanen Leberbiopsie.
Brushes without the plastic tube can also be withdrawn through the instrument channel. Because a large amount of scraped material will be retained in the channel, the procedure should be repeated once or twice. An alternative is to obtain the brushing at the end of the endoscopic examination and to withdraw the brush into the tip of the instrument channel (Fig. 3) to avoid stripping of the material during withdrawal of the endoscope. The cell material must be processed immediately, up to and including fixation, to obtain useable cytologic preparations (Fig.