Document Detail


Prospective evaluation of droperidol on sphincter of Oddi motility.
MedLine Citation:
PMID:  14520277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Droperidol increasingly is used as an effective adjunct for conscious sedation during endoscopic procedures. Given the concern for the effects of narcotics and benzodiazepines on sphincter of Oddi motility, and the potential difficulty in sedating patients undergoing sphincter of Oddi manometry, droperidol could be an ideal agent in this setting. METHODS: Over a 43-month period, consecutive patients undergoing sphincter of Oddi manometry were studied prospectively. Sphincter of Oddi manometry was performed under general anesthesia in all but 10 patients. Standard retrograde pull-through techniques were used to examine the biliary and/or pancreatic sphincter, depending on the indication for sphincter of Oddi manometry. After the initial two pull-throughs, 5 mg of droperidol were given intravenously and measurements were repeated 5 minutes later. RESULTS: A total of 55 patients were studied (42 women [76%], 13 men; mean age 43 years). The basal biliary sphincter pressures measured in 35 patients before and after droperidol were, respectively, 56 mm Hg and 48 mm Hg (p = 0.02); the basal pancreatic sphincter pressures measured in 22 patients before and after droperidol were, respectively, 92 mm Hg and 67 mm Hg (p = 0.29). By using a definition for sphincter of Oddi dysfunction of a basal pressure greater than 40 mm Hg, droperidol would have resulted in a change in diagnosis in 5 patients undergoing biliary manometry (one misclassified as sphincter of Oddi dysfunction, 4 misclassified as normal), and 6 patients undergoing pancreatic sphincter manometry (5 misclassified as sphincter of Oddi dysfunction, one misclassified as normal) (total 19% of procedures). No complication was associated with droperidol use. CONCLUSIONS: Droperidol alters basal sphincter pressures, which in some patients was clinically significant and would have resulted in misclassification. Although safe and well tolerated, droperidol appears to have subtle but clinically significant effects on the sphincter of Oddi.
Authors:
C Mel Wilcox; Jeffrey Linder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  58     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-01     Completed Date:  2004-02-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  483-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Anesthesia / administration & dosage,  pharmacology*
Adolescent
Adult
Aged
Aged, 80 and over
Child
Conscious Sedation
Droperidol / administration & dosage,  pharmacology*
Female
Gastrointestinal Motility / drug effects*
Humans
Male
Manometry
Middle Aged
Prospective Studies
Sphincter of Oddi / drug effects*,  physiology
Chemical
Reg. No./Substance:
0/Adjuvants, Anesthesia; 548-73-2/Droperidol
Comments/Corrections
Comment In:
Gastrointest Endosc. 2003 Oct;58(4):568-70   [PMID:  14520291 ]

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


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