Analgesic effect of meperidine in patients undergoing unsedated colonoscopy

• Main Authors: Ming-Chang, 蔡明璋
• Other Authors: 林俊哲
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/78975475381515534322

碩士 === 中山醫學大學 === 醫學研究所 === 98 === Introduction: Colonoscopy is a standard and useful examination in diagnosis of colorectal disease. But it usually caused painful experience to patients. Those unpleasant effects always made the procedure more difficult. Therefore, most patients received several narcotics, eg. meperidine, for relief of pain during unsedated colonoscopy. Whether administration of sedatives or narcotics to patients will facilitate the performance of colonoscopy or reduce pain need to be elucidated. Purpose: To evaluate the analgesic effect of meperidine as premedication for patients underwent unsedated colonoscopy Method: From July to September 2009, 217 patients (109 men, 108 women) received diagnostic unsedated colonoscopy with one-person & short-axis method by three experienced endoscopists in a medical center. Group A, included 77 patients (mean age 51.6), received 25mg meperidine intramuscularly before colonoscopy. Group B, included 140 patients (mean age 50.7), received no analgesics. Cecum reaching rate, insertion time, and questionnaires to evaluate colonoscopy-related abdominal pain were recorded and analyzed. Pain was graded by visual analog score (VAS) from score 0 to 10. Result: The cecum reaching rate was more than 99 % in both groups. The mean insertion time was 7.14±5.45 minutes in group A and 6.24±4.24 minutes in group B (P=0.309). Pain score was 3.54±3.13 in group A and 2.46±2.75 in group B (P=0.009). The majority of patients in both groups didn’t feel uncomfortable during the whole examination even without sedation, and more than 95 percent of patients agreed that sedation is not mandatory in next colonoscopic examination if needed. Conclusion: In our study, premedication with meperidine did not make patients fell less abdominal pain during unsedated colonoscopy. The total insertion time and cecum reaching rate showed no significant difference between patients with or without meperidine. Premedication with intramuscular meperidine are not absolutely mandatory while performing unsedated colonoscopy under skillful maneuver.