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Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide

Hyoscine-N-butylbromide (HBB) is the most used antiperistaltic agent during esophagogastroduodenoscopy (EGD). However, almost half of the elderly have a contraindication to HBB. We aimed to evaluate l-menthol’s antiperistaltic effect and safety for EGD in the elderly with contraindication to HBB. Th...

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Autores principales: Yang, Tsung-Chieh, Chen, Ping-Hsien, Hou, Ming-Chih, Peng, Li-Ning, Lin, Ming-Hsien, Chen, Liang-Kung, Huang, Yi-Hsiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213511/
https://www.ncbi.nlm.nih.gov/pubmed/35729250
http://dx.doi.org/10.1038/s41598-022-14693-x
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author Yang, Tsung-Chieh
Chen, Ping-Hsien
Hou, Ming-Chih
Peng, Li-Ning
Lin, Ming-Hsien
Chen, Liang-Kung
Huang, Yi-Hsiang
author_facet Yang, Tsung-Chieh
Chen, Ping-Hsien
Hou, Ming-Chih
Peng, Li-Ning
Lin, Ming-Hsien
Chen, Liang-Kung
Huang, Yi-Hsiang
author_sort Yang, Tsung-Chieh
collection PubMed
description Hyoscine-N-butylbromide (HBB) is the most used antiperistaltic agent during esophagogastroduodenoscopy (EGD). However, almost half of the elderly have a contraindication to HBB. We aimed to evaluate l-menthol’s antiperistaltic effect and safety for EGD in the elderly with contraindication to HBB. This prospective, randomized, double-blind, placebo-controlled study screened 86 elderly patients (≥ 65 years old) scheduled to undergo EGD, and 52 of them with contraindication to HBB were enrolled. The participants were randomized to receive l-menthol (n = 26) or a placebo (n = 26), which was locally sprayed on the gastric antrum endoscopically. The proportion of patients with no or mild peristalsis after medication and at the end of EGD was significantly higher in the l-menthol group (76.9%) than in the placebo group (11.5%, p < 0.001). l-Menthol administration significantly reduced peristaltic grade, improved contraction parameters, and eased intragastric examination relative to the placebo (p < 0.001, respectively). Hemodynamic changes, adverse events, and discomfort levels of patients were similar between the two groups. l-Menthol is an effective and safe alternative antiperistaltic medication for EGD in elderly patients with contraindication to HBB. Further large, randomized trials are required to clarify whether l-menthol can lead to better detection yield in the elderly. Clinical trial registration: The study was registered at ClinicalTrials.gov (NCT04593836).
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spelling pubmed-92135112022-06-23 Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide Yang, Tsung-Chieh Chen, Ping-Hsien Hou, Ming-Chih Peng, Li-Ning Lin, Ming-Hsien Chen, Liang-Kung Huang, Yi-Hsiang Sci Rep Article Hyoscine-N-butylbromide (HBB) is the most used antiperistaltic agent during esophagogastroduodenoscopy (EGD). However, almost half of the elderly have a contraindication to HBB. We aimed to evaluate l-menthol’s antiperistaltic effect and safety for EGD in the elderly with contraindication to HBB. This prospective, randomized, double-blind, placebo-controlled study screened 86 elderly patients (≥ 65 years old) scheduled to undergo EGD, and 52 of them with contraindication to HBB were enrolled. The participants were randomized to receive l-menthol (n = 26) or a placebo (n = 26), which was locally sprayed on the gastric antrum endoscopically. The proportion of patients with no or mild peristalsis after medication and at the end of EGD was significantly higher in the l-menthol group (76.9%) than in the placebo group (11.5%, p < 0.001). l-Menthol administration significantly reduced peristaltic grade, improved contraction parameters, and eased intragastric examination relative to the placebo (p < 0.001, respectively). Hemodynamic changes, adverse events, and discomfort levels of patients were similar between the two groups. l-Menthol is an effective and safe alternative antiperistaltic medication for EGD in elderly patients with contraindication to HBB. Further large, randomized trials are required to clarify whether l-menthol can lead to better detection yield in the elderly. Clinical trial registration: The study was registered at ClinicalTrials.gov (NCT04593836). Nature Publishing Group UK 2022-06-21 /pmc/articles/PMC9213511/ /pubmed/35729250 http://dx.doi.org/10.1038/s41598-022-14693-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Yang, Tsung-Chieh
Chen, Ping-Hsien
Hou, Ming-Chih
Peng, Li-Ning
Lin, Ming-Hsien
Chen, Liang-Kung
Huang, Yi-Hsiang
Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title_full Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title_fullStr Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title_full_unstemmed Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title_short Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide
title_sort antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-n-butylbromide
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213511/
https://www.ncbi.nlm.nih.gov/pubmed/35729250
http://dx.doi.org/10.1038/s41598-022-14693-x
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