title: Oral medications for upper gastrointestinal endoscopy using a small diameter endoscope.
abstract: We carried out a double-blinded, randomized prospective study to compare patient tolerance of small diameter endoscopes using limited potency oral premedication to complement topical anesthesia. Patients randomly received either oral placebo, diphenhydramine (100 mg), acetaminophen (1000 mg), or both drugs 30 to 60 min prior to endoscopy. All patients received topical Cetacaine and underwent upper endoscopy with the Olympus XP10 7.9-mm fiberscope. The combination of acetaminophen (1000 mg) and diphenhydramine (100 mg) significantly improved tolerance over topical anesthetic alone. Obvious sedation from the medications was infrequent. Gag response after a topical anesthesia was a significant predictor of patient tolerance. We conclude that small diameter endoscopes are well tolerated for diagnostic upper endoscopy. Oral premedications additionally improve tolerance slightly.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis.
authors.forename: D C
authors.initials: DC
authors.lastname: Pound
authors.forename: K W
authors.initials: KW
authors.lastname: O'Connor
authors.forename: E D
authors.initials: ED
authors.lastname: Brown
authors.forename: R
authors.initials: R
authors.lastname: Weddle
authors.forename: R
authors.initials: R
authors.lastname: McHenry
authors.forename: D
authors.initials: D
authors.lastname: Crabb
authors.forename: R
authors.initials: R
authors.lastname: Brunelle
authors.forename: G A
authors.initials: GA
authors.lastname: Lehman
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000284:Administration, Oral; D000772:Anesthesia, Local; D004155:Diphenhydramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D019723:Endoscopes; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011292:Premedication; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D010919:Placebos; D000082:Acetaminophen; D004155:Diphenhydramine