Safety and efficacy of glycopyrrolate as a premedication for endoscopic submucosal dissection: a randomized, double-blind, placebo-controlled study.
Endoscopy
; 49(10): 949-956, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28637064
ABSTRACT
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications glycopyrrolate (0.004âmg/kg intramuscularly [IM]) or placebo (2.0âmL normal saline solution IM). All patients received the premedication 30 minutes prior to ESD in a double-blind manner. The endoscopists reported the ease of performing the procedure and the incidence of secretion-induced hypoxemia, cough, and other procedure-related adverse events. Results Glycopyrrolate and placebo were received by 96 and 100 patients, respectively. ESD was successfully performed in all patients without any serious adverse events related to sedation or ESD. The median visual analog scale for procedure ease was higher in the glycopyrrolate group at 8 (interquartile range [IQR] 7â-â9) vs. 7 (IQR 6â-â8.25); Pâ<â0.001.âThe proportions of patients with secretion-induced hypoxemia (4.4â% vs. 14.3â%; Pâ=â0.03) and cough (16.7â% vs. 35.7â%; Pâ=â0.005) were lower in the glycopyrrolate group.â Conclusions The use of glycopyrrolate as a premedication for ESD significantly improved the ease of performing the procedure and reduced the incidence of secretion-induced hypoxemia and cough during ESD. Glycopyrrolate may be a promising premedication to ensure safe and stable ESD procedures. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0001540.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Gástricas
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Antagonistas Muscarínicos
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Tos
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Resección Endoscópica de la Mucosa
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Glicopirrolato
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Hipoxia
Tipo de estudio:
Clinical_trials
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Etiology_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endoscopy
Año:
2017
Tipo del documento:
Article