Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double-blind, randomized, controlled study

Authors

  • Yu-Hsi Hsieh,

    Corresponding author
    1. School of Medicine, Buddhist Tzu Chi University, Hwalien
    • Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi
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  • Hwai-Jeng Lin,

    1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
    2. School of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Jin-Jian Hsieh,

    1. Department of Mathematics, National Chung Cheng University, Chia-Yi
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  • Kuo-Chih Tseng,

    1. Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi
    2. School of Medicine, Buddhist Tzu Chi University, Hwalien
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  • Chih-Wei Tseng,

    1. Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi
    2. School of Medicine, Buddhist Tzu Chi University, Hwalien
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  • Tsung-Hsing Hung,

    1. Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi
    2. School of Medicine, Buddhist Tzu Chi University, Hwalien
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  • Felix W. Leung

    1. Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center, North Hill
    2. David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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  • Conflict of interest: The authors have no conflicts of interest to disclose.

Correspondence

Dr Yu-Hsi Hsieh, Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, 2 Min-Sheng Road, Dalin, Chia-Yi 622, Taiwan. Email: hsieh.yuhsi@msa.hinet.net

Abstract

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.

Methods

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.

Results

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.

Conclusions

After receiving meperidine injection, patients had better tolerance and less discomfort during diagnostic EGD (NCT01547520).

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