title: Efficacy of premedication with activated Dimethicone or N-acetylcysteine in improving visibility during upper endoscopy.
abstract: OBJECTIVE
  To assess the efficacy of N-acetylcysteine (NAC) and activated Dimethicone in improving endoscopic mucosal visibility.
  
  
  METHODS
  A total of 148 patients were randomly allocated into four groups to receive one of the following premedications: group A: 100 mL water alone; group B: activated Dimethicone plus water (up to 100 mL); group C: NAC plus water (up to 100 mL); and group D: activated Dimethicone and NAC plus water (up to 100 mL). A single endoscopist blinded to the patients group assessed the gastric mucosal visibility scores (range 1-4) at four sites. The sum of the scores from the four sites was considered as the total mucosal visibility score (TMVS).
  
  
  RESULTS
  The patients in group B showed a significantly lower TMVS than those of groups A and C (P < 0.001). The TMVS in patients of group D was significantly lower than that of groups A and C (P < 0.001). The TMVS did not significantly differ between groups B and D (P > 0.05). The difference between TMVS of groups C and A was not significant (P > 0.05).
  
  
  CONCLUSIONS
  Premedication with activated Dimethicone 20 min prior to the upper endoscopy leads to the best visibility. NAC does not improve visualization by itself.
authors.affiliation: Department of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, 7193711351 Fars, Iran.
authors.forename: Seyed Mohammad Kazem Hosseini
authors.initials: SM
authors.lastname: Asl
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Sivandzadeh
mesh_terms: D000111:Acetylcysteine; D000328:Adult; D000368:Aged; D004129:Dimethylpolysiloxanes; D004311:Double-Blind Method; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011292:Premedication
chemical_list: D004129:Dimethylpolysiloxanes; D010919:Placebos; C509129:dimethicone 20; D000111:Acetylcysteine
references.citation: Gastrointest Endosc. 1991 Sep-Oct;37(5):543-6
references.pmid: 1657680
references.citation: J Zhejiang Univ Sci B. 2009 Jan;10(1):46-51
references.pmid: 19198022
references.citation: Scand J Gastroenterol. 2010 Mar;45(3):357-61
references.pmid: 20148732
references.citation: J Med Assoc Thai. 2010 Aug;93(8):892-7
references.pmid: 20718163
references.citation: World J Gastroenterol. 2009 Jun 28;15(24):3032-7
references.pmid: 19554657
references.citation: Gut. 2005 Jun;54(6):740-2
references.pmid: 15888773
references.citation: Lancet. 1998 May 2;351(9112):1350-2
references.pmid: 9643813
references.citation: Gastrointest Endosc. 1988 May-Jun;34(3):255-8
references.pmid: 3292345
references.citation: Gastrointest Endosc. 1978 Nov;24(6):283
references.pmid: 365670
references.citation: Aliment Pharmacol Ther. 2003 Aug 1;18(3):327-32
references.pmid: 12895217
references.citation: Gastrointest Endosc. 2004 Apr;59(4):487-91
references.pmid: 15044883
references.citation: Gut. 1997 Sep;41(3):308-13
references.pmid: 9378383
references.citation: Gut. 2001 Feb;48(2):225-9
references.pmid: 11156645
references.citation: Endoscopy. 2002 Jul;34(7):531-4
references.pmid: 12170403
references.citation: World J Gastroenterol. 2007 Jan 21;13(3):444-7
references.pmid: 17230616
references.citation: Gastrointest Endosc. 1998 May;47(5):382-7
references.pmid: 9609431
references.citation: Gut. 1992 Oct;33(10):1318-22
references.pmid: 1446852
references.citation: World J Gastroenterol. 2006 Aug 14;12(30):4873-4
references.pmid: 16937471
references.citation: Int J Cancer. 2002 Feb 20;97(6):811-8
references.pmid: 11857360
references.citation: J Clin Gastroenterol. 1992 Oct;15(3):264-5
references.pmid: 1479177