INTRAVENOUS KETOROLAC TROMETHAMINE VERSUS MEPERIDINE FOR ADJUNCTIVE SEDATION IN UPPER GASTROINTESTINAL ENDOSCOPY - A PILOT-STUDY

Background: Meperidine is commonly used with a benzodiazepine to achie ve conscious sedation but may potentiate respiratory depression. Ketor olac tromethamine has few sedative effects and no respiratory depressi on. The purpose of this study was to compare ketorolac to meperidine a s adjuncts in conscious sedation for upper gastrointestinal endoscopy (EDG). Methods: Patients undergoing diagnostic EGD (n = 47) were rando mly assigned to receive normal saline solution or 50 mg meperidine or 30 mg ketorolac intravenously. Midazolam was subsequently administered (as needed, to achieve adequate conscious sedation) by endoscopists w ho were blinded to the test substance given before the procedure. Resu lts: For all treatment groups, there was no significant difference in extent or adequacy of sedation, incidence of oxygen desaturation, pati ent amnesia, time of procedure, or vital signs (except for a relative procedural tachycardia in the ketorolac and placebo groups as compared to baseline). The keterolac group experienced more pain and anxiety. The meperidine group experienced less gagging, a shorter sedation time , less midazolam usage, and more discomfort at the intravenous site. M eperidine seemed to offer a ''protective'' effect against procedural t achycardia. Conclusion: There is no benefit to ketorolac as an adjunct in conscious sedation for EGD. Meperidine had several benefits; howev er, discomfort at the intravenous site was common.