title: Peppermint oil solution is useful as an antispasmodic drug for esophagogastroduodenoscopy, especially for elderly patients.
abstract: BACKGROUND
  Although hyoscine butyl bromide (HB) and glucagon (GL) are often used as antispasmodic drugs during esophagogastroduodenoscopy (EGD), these agents may cause adverse effects. Recently, it was reported that peppermint oil solution (PO) was very effective and had few side effects.
  
  
  OBJECTIVE
  We clarified the efficacy and usefulness of PO as an antispasmodic during upper endoscopy, especially for elderly patients.
  
  
  METHODS
  This study was a non-randomized prospective study. The antispasmodic score (1-5, where 5 represents no spasm) was defined according to the degree of spasms of the antrum and difficulty of biopsy. We compared the antispasmodic scores between non-elderly patients (younger than 70) and elderly patients (70 years old or older) according to the antispasmodic agent.
  
  
  RESULTS
  A total of 8,269 (Group PO: HB: GL: NO (no antispasmodic) = 1,893: 6,063: 157: 156) EGD procedures were performed. There was no significant difference in the antispasmodic score between Group PO (mean score ± standard deviation: 4.025 ± 0.925) and Group HB (4.063 ± 0.887). Among the non-elderly patients, those in Group PO (n = 599, 3.923 ± 0.935) had a worse antispasmodic score than those in Group HB (n = 4,583, 4.062 ± 0.876, P < 0.001). However, among the elderly patients, those in Group PO (n = 1,294, 4.073 ± 0.917) had similar scores to those in Group HB (n = 1,480, 4.064 ± 0.921, P = 0.83), and significantly better scores than those in Group GL (n = 69, 3.797 ± 0.933, P < 0.05).
  
  
  CONCLUSIONS
  Peppermint oil was useful as an antispasmodic during EGD, especially for elderly patients.
authors.affiliation: Department of Gastroenterology, Mitoyo General Hospital, 708 Himehama, Toyohama, Kan-onji, Kagawa 769-1695, Japan. imagawa-gi@umin.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imagawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hata
authors.forename: Morihito
authors.initials: M
authors.lastname: Nakatsu
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Keiko
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Inokuchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Imada
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kohno
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahara
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Miyatake
authors.forename: Satoru
authors.initials: S
authors.lastname: Yagi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ando
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hirohata
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Fujiki
authors.forename: Ryuta
authors.initials: R
authors.lastname: Takenaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage / Q000494:pharmacology; D016145:Endoscopy, Digestive System; D005260:Female; D005934:Glucagon / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D008297:Male; D036142:Mentha piperita; D008875:Middle Aged; D010276:Parasympatholytics / Q000008:administration & dosage / Q000494:pharmacology*; D010938:Plant Oils / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D010276:Parasympatholytics; D010938:Plant Oils; D002086:Butylscopolammonium Bromide; D005934:Glucagon; C015424:peppermint oil