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Background: Gl endoscopy without general anesthesia causes a hyperperistaltic state in the stomach,
which frequently necessitates the use of antispasmodic agents, such as hyoscine-N-butylbromide,
but these drugs have side effects. Peppermint oil is harmless and acts locally to
inhibit Gl smooth muscle contraction.
Methods: A randomized double-blind, double-dummy, controlled trial was conducted in 100 patients
to compare the antispasmodic effects of hyoscine-N-butylbromide administered intramuscularly
and a placebo solution administered intraluminally by means of the endoscope, and
also the effects of a placebo solution administered intramuscularly with those of
a peppermint oil solution administered intraluminally. The percent change in diameter
of the pyloric ring before and after the administrations was defined as the opening
ratio, and the percent change in diameter between the maximally and minimally opened
pyloric ring states was defined as the contraction ratio. Time until disappearance
of the contraction ring(s) in the gastric antrum and side effects of the drugs were
also determined.
Results: The opening ratio was significantly higher in the peppermint oil administration group
than in the hyoscine-N-butylbromide injection group. The contraction ratio after peppermint
oil administration was significantly lower than that after hyoscine-N-butylbromide
injection. The time required for disappearance of the antral contraction ring(s) was
shorter in the peppermint oil group (97.1±11.4) than in the hyoscine-N-butylbromide
group (185.9±10.1 s; p<0.0001). No significant side effects were associated with peppermint oil, whereas
hyoscine-N-butylbromide injection produced side effects such as dry mouth, blurred
vision, and urinary retention.
Conclusions: Peppermint oil solution administered intraluminally can be used as an antispasmodic
agent with superior efficacy and fewer side effects than hyoscine-N-butylbromide administered
by intramuscular injection during upper endoscopy.
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Article info
Publication history
Accepted:
October 12,
2002
Received in revised form:
September 7,
2002
Received:
April 1,
2002
Identification
Copyright
© 2003 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc.
