The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP)
Background: Deep sedation is essential during endoscopic retrograde cholangiopancreatography (ERCP) in order to achieve therapeutic goals and avoid complication. Therefore, providing a suitable sedation is critical for the patients. The most common sedation protocol includes an intravenous (IV) benz...
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| Format: | Article |
| Language: | fas |
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Isfahan University of Medical Sciences
2017-12-01
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| Series: | مجله دانشکده پزشکی اصفهان |
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| Online Access: | http://jims.mui.ac.ir/index.php/jims/article/view/7581 |
| _version_ | 1797716709754273792 |
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| author | Parvin Sajedi Hamed Manzari-Tavakoli |
| author_facet | Parvin Sajedi Hamed Manzari-Tavakoli |
| author_sort | Parvin Sajedi |
| collection | DOAJ |
| description | Background: Deep sedation is essential during endoscopic retrograde cholangiopancreatography (ERCP) in order to achieve therapeutic goals and avoid complication. Therefore, providing a suitable sedation is critical for the patients. The most common sedation protocol includes an intravenous (IV) benzodiazepine along with an intravenous narcotic. For the difficult-to-sedate patients, like addicted patients, general anesthesia should be considered as an alternative. Meperidine is commonly used because of the traditional belief that other narcotic agents may be associated with contraction of Oddi. However, it seems that using morphine for addicted patients may cause deeper sedation without Oddi sphincter contraction.
Methods: This was a clinical trial study on 88 ERCP-candidate addicted patients assigned into two groups. The case group received morphine before starting ERCP and the control group only received the routine sedation regimen. The degree of sedation, patient movements, and the status of the sphincter of Oddi were evaluated during procedure time.
Findings: The data about 44 patients of the case and 40 patients of control groups were analyzed. The mean age was 58.52 ± 1.11 years. Evaluating the degree of sedation every 15 minutes during ERCP showed significant differences between the case and control group. In case group, the degree of sedation was significantly deeper. Furthermore, Oddi sphincter showed a significantly increased contraction in case group. However, only in one patient procedure failed.
Conclusion: Administration of morphine in addicted patients can make deeper sedation during ERCP, without any significant problem related to contraction of the sphincter of Oddi. |
| first_indexed | 2024-03-12T08:25:30Z |
| format | Article |
| id | doaj.art-2f72df37c8844efab102bb8f380075ca |
| institution | Directory Open Access Journal |
| issn | 1027-7595 1735-854X |
| language | fas |
| last_indexed | 2024-03-12T08:25:30Z |
| publishDate | 2017-12-01 |
| publisher | Isfahan University of Medical Sciences |
| record_format | Article |
| series | مجله دانشکده پزشکی اصفهان |
| spelling | doaj.art-2f72df37c8844efab102bb8f380075ca2023-09-02T18:07:49ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2017-12-0135450139614042685The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP)Parvin Sajedi0Hamed Manzari-Tavakoli1Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranBackground: Deep sedation is essential during endoscopic retrograde cholangiopancreatography (ERCP) in order to achieve therapeutic goals and avoid complication. Therefore, providing a suitable sedation is critical for the patients. The most common sedation protocol includes an intravenous (IV) benzodiazepine along with an intravenous narcotic. For the difficult-to-sedate patients, like addicted patients, general anesthesia should be considered as an alternative. Meperidine is commonly used because of the traditional belief that other narcotic agents may be associated with contraction of Oddi. However, it seems that using morphine for addicted patients may cause deeper sedation without Oddi sphincter contraction. Methods: This was a clinical trial study on 88 ERCP-candidate addicted patients assigned into two groups. The case group received morphine before starting ERCP and the control group only received the routine sedation regimen. The degree of sedation, patient movements, and the status of the sphincter of Oddi were evaluated during procedure time. Findings: The data about 44 patients of the case and 40 patients of control groups were analyzed. The mean age was 58.52 ± 1.11 years. Evaluating the degree of sedation every 15 minutes during ERCP showed significant differences between the case and control group. In case group, the degree of sedation was significantly deeper. Furthermore, Oddi sphincter showed a significantly increased contraction in case group. However, only in one patient procedure failed. Conclusion: Administration of morphine in addicted patients can make deeper sedation during ERCP, without any significant problem related to contraction of the sphincter of Oddi.http://jims.mui.ac.ir/index.php/jims/article/view/7581Deep sedationMorphine dependenceEndoscopic retrograde cholangiopancreatography |
| spellingShingle | Parvin Sajedi Hamed Manzari-Tavakoli The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) مجله دانشکده پزشکی اصفهان Deep sedation Morphine dependence Endoscopic retrograde cholangiopancreatography |
| title | The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) |
| title_full | The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) |
| title_fullStr | The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) |
| title_full_unstemmed | The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) |
| title_short | The Effect of Morphine on the Sedation of Addicted Patients during Endoscopic Retrograde Cholangiopancreatography (ERCP) |
| title_sort | effect of morphine on the sedation of addicted patients during endoscopic retrograde cholangiopancreatography ercp |
| topic | Deep sedation Morphine dependence Endoscopic retrograde cholangiopancreatography |
| url | http://jims.mui.ac.ir/index.php/jims/article/view/7581 |
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