Conflict of interest: The authors have no conflicts of interest to disclose.
Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double-blind, randomized, controlled study
Article first published online: 20 JUN 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 7, pages 1167–1173, July 2013
How to Cite
Hsieh, Y.-H., Lin, H.-J., Hsieh, J.-J., Tseng, K.-C., Tseng, C.-W., Hung, T.-H. and Leung, F. W. (2013), Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double-blind, randomized, controlled study. Journal of Gastroenterology and Hepatology, 28: 1167–1173. doi: 10.1111/jgh.12183
- Issue published online: 20 JUN 2013
- Article first published online: 20 JUN 2013
- Accepted manuscript online: 22 FEB 2013 10:04AM EST
- Manuscript Accepted: 11 FEB 2013
- Buddhist Dalin Tzu Chi General Hospital
- minimal sedation
Background and Aim
In Taiwan, unsedated esophagogastroduodenoscopy (EGD) is widely used, but it is uncomfortable for some patients. While meperidine has been adopted in colonoscopy, its use in EGD has not received extensive attention. This was a prospective study to investigate the use of meperidine as a single sedative agent during EGD.
One hundred and forty patients were randomized to receive either 25-mg meperidine (n = 70) or placebo (n = 70) by intramuscular injection before EGD. The primary outcome was patient discomfort scores. The secondary outcomes included patient, endoscopist, and EGD-related variables.
Patients in the meperidine group reported less discomfort during esophageal intubation (median score of 2.0 and interquartile range [IQR] of 0–4.0 vs median score of 4.8 and IQR of 1.7–7.0, respectively; P < 0.001) and during the procedure (median score of 1.0 [IQR 0–3.1] vs 3.5 [IQR 0–5.6], P = 0.001) than patients in the placebo group. The endoscopist found patients in the meperidine group had better tolerance during esophageal intubation (median score of 1.0 [IQR 0–2.0] vs 2.0 [IQR 1.0–3.0], P = 0.021) and during the procedure (median score of 0 [IQR 0–1.0] vs 1.0 [IQR 0–3.0], P < 0.001). After the procedure more patients in the meperidine group (71.4% vs 35.7%, P < 0.001) experienced self-limited dizziness that prolonged recovery by ∼3.7 min.
After receiving meperidine injection, patients had better tolerance and less discomfort during diagnostic EGD (NCT01547520).