Dataset Information

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 = 55) or placebo (n = 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 = .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 = .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 = .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 = .006); (7 mmHg (IQR 1-14) versus 18 mmHg (IQR 2-30); P = .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.

SUBMITTER: Tseng CW

PROVIDER: S-EPMC6206533 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

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

Tseng Chih-Wei CW Koo Malcolm M Tseng Kuo-Chih KC Hsieh Yu-Hsi YH

United European gastroenterology journal 20180824 9

<h4>Background</h4>Anxious patients and those with poor tolerance to previous esophagogastroduodenoscopy (EGD) usually have poor tolerance for EGD.<h4>Aims</h4>To investigate the effect of meperidine on these patients during EGD.<h4>Methods</h4>A total of 110 patients undergoing diagnostic EGD were randomized to receive either meperidine (<i>n</i> = 55) or placebo (<i>n</i> = 55) before EGD. The primary outcome was patient discomfort scores during esophageal intubation.<h4>Results</h4>Patients i ...[more]

PMID: 30386603

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Project description:BackgroundEsophagogastroduodenoscopy (EGD) provides an indispensable and unambiguous inspection allowing the discovery upper gastrointestinal lesions. However, many patients are anxious about undergoing EGD. Few studies have investigated the influence on patients' vital signs and tolerance during EGD using subjective and objective assessments. This study was a prospective randomized controlled study that investigated the influence of audio and visual distraction on EGD.MethodsWe randomly divided 289 subjects who underwent EGD into 4 groups (control group, audio group, visual group, combination group) and examined their vital signs, heart rate variability (HRV), psychological items, and acceptance of distraction.ResultsPulse rate (PR) at post-distraction and post-EGD in the 3 distraction groups were significantly lower than those of control group (p < 0.001 and p < 0.01, respectively). Blood pressure (BP) during and post-EGD was significantly higher than that at pre-EGD in control group (p < 0.05), but no significant elevation of BP was observed during the latter half of EGD and post-EGD in the 3 distraction groups. BP at post-distraction improved significantly compared to pre-distraction in the 3 distraction groups (p < 0.05). There was a significant difference in the low-frequency (LF) power/ high-frequency (HF) power at post-distraction and post-EGD among the 4 groups (p < 0.001 and p < 0.001, respectively). The LF power/HF power at post-distraction and post-EGD in the 3 distraction groups was significantly lower than that in control group (p < 0.05). Several items of profile of mood states (POMS) and the impression of EGD at post-distraction improved significantly compared to those at pre-distraction among the 3 distraction groups (p < 0.05). Visual analog scale (VAS) of willingness for the next use of distraction in the 3 distraction groups was excellent because VAS was more than 70.ConclusionsDistractions effectively improved psychological factors, vital signs and some of HRV at pre and post-EGD. Distractions may suppress BP elevation during the latter half of EGD and lead to stability of HRV on EGD.Trial registrationThis prospective trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000029637. Registered on 20 October 2017.

Dataset Information

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

Background

Aims

Methods

Results

Conclusion

Publications

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

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