Safety and efficacy of glucagon as a premedication for upper gastrointestinal endoscopy—a comparative study with butyl scopolamine bromide

Abstract

Background: Glucagon inhibits digestive motility and is used for endoscopic premedication; however, its effect on cardiopulmonary function during endoscopy has not yet been fully investigated. Aim: To clarify the efficacy and safety of glucagon compared with butyl scopolamine bromide as upper gastrointestinal endoscopy premedication. Methods: Two hundred and forty consecutive patients over 40 years of age, referred for upper gastrointestinal endoscopy, without any complications, were studied. These patients were randomly premedicated with butyl scopolamine bromide (SC group) or glucagon (G group). Time course changes in blood pressure, arterial oxygen saturation, heart rate and the number of retching episodes during endoscopy were examined. The efficacy of glucose tablets after upper gastrointestinal endoscopy to prevent hypoglycaemia caused by glucagon was evaluated. Cardiopulmonary parameters were also examined in 77 complicated patients with glucagon premedication (GC group). Results: A continuous increase in heart rate during upper gastrointestinal endoscopy was observed in the SC group, but not in the G and GC groups. Blood pressure, arterial oxygen saturation and number of retching episodes were not different between the groups. Hypoglycaemia‐related symptoms were frequent in the G group without glucose tablets, but were prevented by the administration of glucose. Conclusions: Glucagon has a weaker effect on cardiopulmonary function during upper gastrointestinal endoscopy than butyl scopolamine bromide. Glucose administration prevents hypoglycaemia‐related symptoms caused by glucagon.

Comparison of gastric peristalsis inhibition by scopolamine butylbromide and glucagon: evaluation by electrogastrography and analysis of heart rate variability

“…In addition, certain hypoglycemic symptoms were reported in some patients who fasted for 5 h after gastrointestinal endoscopy following premedication with glucagon. 30 In the present study, because the subjects treated with glucagon complained of hypoglycemic symptoms after prolonged fasting, sympathetic nervous activity might have increased during that period. Therefore, as indicated, we cannot simply conclude that glucagon is a safe drug for the elderly and for those with cardiopulmonary complications because of the presence of these hypoglycemic side effects, although no subjects in this study complained of hypoglycemic symptoms during the first 120 min after glucagon administration.…”

An open-label, single-arm study assessing the efficacy and safety of l-menthol sprayed onto the gastric mucosa during upper gastrointestinal endoscopy

“…Hyoscine-N-butylbromide is associated with cardiovascular events, and glucagon can lead to delayed hypoglycemia [4,5]. Another disadvantage is that these conventional antispasmodic agents are administered by injection, inevitably causing pain.…”

The modern endoscopic investigation of the stomach with the application of the narrow-band imaging endoscopy and magnifying endoscopy: procedural techniques and diagnostic algorithms

“…Для снижения перистальтики ис пользуют внутривенное или внутримышечное вве дение спазмолитических препаратов, таких как гио сцина бутилбромид (10-40 мг) или глюкагон (1 мг) [21,22]. Эти препараты вводятся непосредственно перед исследованием и далее во время эндоскопи ческой процедуры.…”