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