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.
We clarified the efficacy and usefulness of PO as an antispasmodic during upper endoscopy, especially for elderly patients.
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.
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).
Peppermint oil was useful as an antispasmodic during EGD, especially for elderly patients.
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The authors thank Ms Sachiyo Kondo, a member of the Department of Pharmacy, Tsuyama Central Hospital, and Mr Masashi Katagiri and Mr Eiji Mukai, members of the Department of Pharmacy, Mitoyo General Hospital, for their cooperation and assistance in this study. The authors thank Dr Yasuhiro Miyake for assistance in the preparation of this manuscript.
Conflict of interest
No conflicts of interest exist.
Clinical trial registration number: UMIN00000 4710.
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Imagawa, A., Hata, H., Nakatsu, M. et al. Peppermint Oil Solution Is Useful as an Antispasmodic Drug for Esophagogastroduodenoscopy, Especially for Elderly Patients. Dig Dis Sci 57, 2379–2384 (2012). https://doi.org/10.1007/s10620-012-2194-4
- Antispasmodic drug
- Peppermint oil