Meperidine as the single sedative agent during esophagogastroduodenoscopy, a double-blind, randomized, controlled study

Background and Aim: In Taiwan, unsedated esophagogastroduodenoscopy (EGD) is widely used, but it is uncomfortable for some patients. While meperidine has been adopted in colonoscopy, its use in EGD has not received extensive attention. This was a prospective study to investigate the use of meperidine as a single sedative agent during EGD. Methods: One hundred and forty patients were randomized to receive either 25-mg meperidine (n=70) or placebo (n=70) by intramuscular injection before EGD. The primary outcome was patient discomfort scores. The secondary outcomes included patient, endoscopist, and EGD-related variables. Results: Patients in the meperidine group reported less discomfort during esophageal intubation (median score of 2.0 and interquartile range [IQR] of 0-4.0 vs median score of 4.8 and IQR of 1.7-7.0, respectively; P<0.001) and during the procedure (median score of 1.0 [IQR 0-3.1] vs 3.5 [IQR 0-5.6], P=0.001) than patients in the placebo group. The endoscopist found patients in the meperidine group had better tolerance during esophageal intubation (median score of 1.0 [IQR 0-2.0] vs 2.0 [IQR 1.0-3.0], P=0.021) and during the procedure (median score of 0 [IQR 0-1.0] vs 1.0 [IQR 0-3.0], P<0.001). After the procedure more patients in the meperidine group (71.4% vs 35.7%, P<0.001) experienced self-limited dizziness that prolonged recovery by ∼3.7min. Conclusions: After receiving meperidine injection, patients had better tolerance and less discomfort during diagnostic EGD (NCT01547520).