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

Abstract

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.

A Randomized Comparative Study of the Effects of Pethidine and Midazolam on the Extent of Esophagogastric Junction Examination

“…It is commonly used in combination with a benzodiazepine, 19,20) but use as a single agent has been reported, and used singly, it has been shown to minimize patients' discomfort, prevent cardiovascular overload, and increase endoscopists' satisfaction. 21) The advantage of pethidine is that it is conscious sedation, which allows the patient to follow the endoscopist's instructions regarding breathing. This allows for adjustment of the EGJ observation range.…”

Nebulised dexmedetomidine for patient’s comfort and satisfaction during diagnostic upper gastrointestinal endoscopy: A double-blind randomised controlled study

“…The primary outcome was the patient’s satisfaction score (PSS) on a Likert scale of 0–10 (0 – not satisfied at all; 10 – very satisfied) as evaluated by the patient. [ 8 ] The secondary outcomes included endoscopist-reported outcomes - ‘ease of procedure’ (0 – most difficult; 10 –very easy) and ‘patient tolerance to procedure’ (0 – unbearable; 10 – none); an assistant blinded to the study drugs counted the number of coughing and retching episodes during the procedure. Demographic data (age, sex and weight) and anxiety scores (0 – not anxious; 10 – extremely anxious) were obtained before UGE.…”