ABSTRACT
Objective:To evaluate the effects of single spay of L-menthol (NPO-11) on suppressing gastric peristalsis during upper gastrointestinal endoscopy and the influencing factor.Methods:This study was a multicenter, randomized, double-blind, placebo-parallel controlled study. The eligible patients were randomly divided into two groups by randomized blocks. Patients received local spray of either NPO-11 (160 mg L-menthol) or placebo 20 mL during upper gastrointestinal endoscopy. The gastric peristalsis was recorded and evaluated before, 2 minutes after and at the end of endoscopy. The complexity of the procedure was evaluated by the researchers. The influencing factors for antiperistaltic effect of NPO-11 were analyzed.Results:A total of 220 patients were enrolled from five research centers. There were 109 cases in the NPO-11 group and 111 cases in the placebo group. The baseline data of the two groups were similar and comparable. The proportion of patients with grade 1 peristalsis at 2 minutes after the treatment and at the end of endoscopy was significantly higher in the NPO-11 group than that in the placebo group [40.37% (44/109) VS 16.22% (18/111), χ2=15.93, P<0.001]. Compared with the placebo group, the proportions of weak peristalsis (grade 1 and 2) were higher in the NPO-11 group at 2 minutes after the treatment [67.89% (74/109) VS 46.85% (52/111)] and at the end of endoscopy [79.82% (87/109) VS 48.65% (54/111)]. Subgroup analysis showed that the inhibitory effect of NPO-11 on gastric peristalsis was more significant in Helicobacter pylori antibody positive group. Conclusion:Local spray of NPO-11 can effectively inhibit gastric peristalsis during upper gastrointestinal endoscopy, and its effect is more significant in Helicobacter pylori antibody positive group. It could be recommended for no obvious adverse reactions , its safety, and the convenient procedure.
ABSTRACT
[Objective] It is necessary to administer anti-cholinergic agents or glucagon during gastroscopy for inhibition of gastric peristalsis. However, application of these drugs are limited in patients with glaucoma, hypertension, benign prostate hyperplasia, heart disease, or diabetes mellitus because of possible adverse events.<BR>Based on the report that acupuncture stimulation at CV 12 (Zhonguan, Chukan) inhibited gastric activity, we studied whether the acupuncture at CV 12 could be applicable as an alternative to these drugs.<BR>[Method] Subjects in the present study were 60 patients who underwent gastroscopy at Meiji University of Oriental Medicine Hospital. They were allocated into two groups; acupuncture group (mean [SD] age, 66 [10]) and drug group (mean [SD] age, 64 [13])<BR>Patients in the acupuncture group were given manual stimulation at CV 12 with an acupuncture needle for 10 minutes before examination and during gastroscopy.<BR>After examination, a gastroscopist evaluated the magnitude of the peristalsis and disturbance during the examination using the visual analogue scale (VAS) and a 4-grade categorical scale.<BR>Patients in the drug group were pre-administered anti-cholinergic drug or glucagon, and evaluated with the same scale.<BR>[Results and Discussion] Inhibition score in the acupuncture group was lower but not statistically significant, as compared with the drug group, and the effect of acupuncture stimulation was acceptable to allow examination of the patients without severe disturbance. <BR>Acupuncture may be a useful non-pharmacologic alternative to anti-cholinergic drugs and glucagon to inhibit gastric movement during gastroscopy, when these drugs could not be administered.