Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double‐blind, randomized, controlled study

Hsieh, Yu Hsi; Lin, Hwai Jeng; Hsieh, Jin Jian; Tseng, Kuo‐Chih; Tseng, Chih‐Wei; Hung, Tsung–Hsing; Leung, Felix W.

doi:10.1111/jgh.12183

Cited by 6 publications

(15 citation statements)

References 23 publications

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“…Peri-endoscopic sedative and analgesic medications have often been used to provide patient comfort, reduce procedure time, and improve examination quality during EGD. ( 9 – 11 ) Benzodiazepines such as midazolam are the most commonly used sedatives, ( 12 , 13 ) and these are generally given to the patient along with an opiate (pethidine or fentanyl) for synergism. ( 14 , 15 ) Two randomized controlled trials compared sedation with midazolam plus pethidine versus midazolam alone.…”

Section: Discussionmentioning

confidence: 99%

Pethidine dose and female sex as risk factors for nausea after esophagogastroduodenoscopy

Nishizawa¹,

Suzuki

Arita³

et al. 2018

J. Clin. Biochem. Nutr.

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Nausea and vomiting after esophagogastroduodenoscopy have not been studied in detail. The aim of this study was to evaluate the risk factors for post-endoscopic nausea. We performed a case-control study at the Toyoshima Endoscopy Clinic. Eighteen patients with post-endoscopic nausea and 190 controls without post-endoscopic nausea were analyzed. We conducted univariate and multivariate logistic regression analyses with respect to patient age; sex; body height; body weight; the use of psychotropic drugs as baseline medications; and the dosing amounts of midazolam, pethidine, flumazenil and naloxone. On univariate analysis, post-endoscopic nausea was significantly related with patient age (odds ratio = 0.946); female sex (odds ratio = 10.85); body weight (odds ratio = 0.975); and the dose per kg body weight of pethidine (odds ratio = 53.03), naloxone (odds ratio = 1.676), and flumazenil (odds ratio = 1.26). On multivariate analysis, the dose per kg body weight of pethidine (odds ratio = 21.67, p = 0.004) and female sex (odds ratio = 13.12, p = 0.047) were the factors independently associated with post-endoscopic nausea. The prevalence of nausea after esophagogastroduodenoscopy was 0.49% (18/3,654). In conclusion, post-endoscopic nausea was associated with the dose of pethidine and female sex.

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Section: Discussionmentioning

confidence: 99%

Pethidine dose and female sex as risk factors for nausea after esophagogastroduodenoscopy

Nishizawa¹,

Suzuki

Arita³

et al. 2018

J. Clin. Biochem. Nutr.

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“…Although sedation for EGD is widely utilized in the USA, 1 its use varies in Europe and Asia. [2][3][4][5] From the perspective of the patients, sedation for EGD has the benefit of improving satisfaction, eliminating anxiety and discomfort, and increasing the willingness to repeat the procedures. [6][7][8] For the endoscopists, sedation can improve the success rate and quality of examination for diagnostic EGD, as well as enhance the treatment outcomes of therapeutic EGD.…”

Section: Introductionmentioning

confidence: 99%

Meperidine for patients expected to have poor tolerance to esophagogastroduodenoscopy: A double‐blind, randomized, controlled study

et al. 2018

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Background: Anxious patients and those with poor tolerance to previous esophagogastroduodenoscopy (EGD) usually have poor tolerance for EGD. Aims: To investigate the effect of meperidine on these patients during EGD. Methods: A total of 110 patients undergoing diagnostic EGD were randomized to receive either meperidine (n ¼ 55) or placebo (n ¼ 55) before EGD. The primary outcome was patient discomfort scores during esophageal intubation. Results: Patients in the meperidine group reported less discomfort during esophageal intubation (median score of 5.0 and interquartile range (IQR) 1.5-7.0) compared with the control (median score of 6.0, IQR 5.0-8.5, P ¼.003). Patients in the meperidine group had better tolerance during the procedure (median score of 2 (IQR 1.0-3.0) versus 3 (IQR 1.0-4.0), P ¼.048), and the endoscopists reported higher overall satisfaction scores (median score of 9 (IQR 7.0-9.0) versus 8 (IQR 7.0-9.0), P ¼.043). There was significantly less increase in heart rate and blood pressure during the procedure in the meperidine group than in the placebo group (23 bpm (IQR 9-32) versus 30 bpm (IQR 18-52); P ¼.006); (7 mmHg (IQR 1-14) versus 18 mmHg (IQR 2-30); P ¼.008). Connect-the-numbers test showed comparable results before and after EGD between the two groups. Conclusion: For patients expected to have poor tolerance during EGD, meperidine reduced discomfort, decreased cardiovascular distress, and improved endoscopist satisfaction, without adverse effects on their psychomotor function after the procedure.

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“…Indeed, a previous study failed to demonstrate any benefit from use of benzodiazepines for observation of the pyriform sinus . Opioids are another option for UGIE, which can achieve conscious sedation . Using opioids, it is possible to obtain patient cooperation while reducing the gag reflex and discomfort.…”

Section: Introductionmentioning

confidence: 99%

“…20 Opioids are another option for UGIE, which can achieve conscious sedation. 23,24 Using opioids, it is possible to obtain patient cooperation while reducing the gag reflex and discomfort. This drug may provide the best conditions for pharyngeal observation; however, no previous studies have evaluated the utility of this drug.…”

Section: Introductionmentioning

confidence: 99%

Pethidine hydrochloride is a better sedation method for pharyngeal observation by transoral endoscopy compared with no sedation and midazolam

Yamasaki

Ishihara

Hanaoka

et al. 2016

Digestive Endoscopy

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Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double‐blind, randomized, controlled study

Abstract: After receiving meperidine injection, patients had better tolerance and less discomfort during diagnostic EGD (NCT01547520).

Cited by 6 publications

References 23 publications

Pethidine dose and female sex as risk factors for nausea after esophagogastroduodenoscopy

Pethidine dose and female sex as risk factors for nausea after esophagogastroduodenoscopy

Meperidine for patients expected to have poor tolerance to esophagogastroduodenoscopy: A double‐blind, randomized, controlled study

Pethidine hydrochloride is a better sedation method for pharyngeal observation by transoral endoscopy compared with no sedation and midazolam

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