Document Detail


Clinical trial: a randomized, study comparing meperidine (pethidine) and fentanyl in adult gastrointestinal endoscopy.
MedLine Citation:
PMID:  19154568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is little evidence to guide choice between meperidine (pethidine) and fentanyl for sedation for gastrointestinal endoscopy. AIM: To compare meperidine with fentanyl in terms of procedure time and analgesia. METHODS: Single centre randomized controlled trial. Patients received narcotic doses and midazolam at the discretion of the attending endoscopist who was unaware of narcotic assignment. Endoscopy and recovery times were then recorded. The main outcome was total procedure time, defined as endoscopy time plus recovery time. Patient discomfort was assessed prior to discharge via visual analogue scale (VAS). RESULTS: In total, 55 patients were randomized to meperidine [44 colonoscopy and 11 esophagogastroduodenoscopy (EGD)] and 56 to fentanyl (45 colonoscopy and 11 EGD). Total procedure time was shorter for those receiving fentanyl (mean = 87.7 min) than for those receiving meperidine (mean = 102.9 min) (P = 0.05). The difference between the groups was explained by a shorter mean recovery time in the fentanyl group (63.0 min) than in the meperidine group (76.2 min) (P = 0.07). Based on post procedure pain scores, examinations with meperidine (mean = 1.99) were less painful when compared with those receiving fentanyl (mean = 2.86, P = 0.03). CONCLUSIONS: Fentanyl shortened total procedure time by reducing recovery time. A simple change in narcotic choice could increase endoscopy unit efficiency.
Authors:
D J Robertson; D P Jacobs; T A Mackenzie; J A Oringer; R I Rothstein
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2009-01-20
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  29     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-02     Completed Date:  2009-09-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  817-23     Citation Subset:  IM    
Affiliation:
VA Medical Center, White River Junction, VT 05009, USA. douglas.robertson@med.va.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / administration & dosage*
Anesthesia Recovery Period
Anesthetics, Intravenous / administration & dosage
Conscious Sedation / methods*
Endoscopy, Gastrointestinal / methods*
Female
Fentanyl / administration & dosage*
Humans
Male
Meperidine / administration & dosage*
Middle Aged
Pain Measurement
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Intravenous; 437-38-7/Fentanyl; 57-42-1/Meperidine
Comments/Corrections
Comment In:
Aliment Pharmacol Ther. 2009 Aug;30(3):312-3; author reply 313   [PMID:  19624467 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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