Same-day opioid administration in opiate naïve patients is not associated with opioid-induced esophageal dysfunction (OIED)
| Autor: | Jeffrey A. Alexander, Ryan A. Balko, Joseph A. Murray, David A. Katzka, Karthik Ravi, Kristin C. Mara |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Chest Pain Physiology Manometry Midazolam Conscious Sedation Subgroup analysis Gastroenterology Fentanyl 03 medical and health sciences 0302 clinical medicine Esophagus Internal medicine medicine Humans Esophageal Motility Disorders Endoscopy Digestive System Dyspepsia Aged Endocrine and Autonomic Systems business.industry Middle Aged Dysphagia Pathophysiology Analgesics Opioid medicine.anatomical_structure Opioid 030220 oncology & carcinogenesis Gastroesophageal Reflux 030211 gastroenterology & hepatology Female medicine.symptom Opiate Complication business Deglutition Disorders Anesthetics Intravenous medicine.drug |
| Zdroj: | Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility SocietyREFERENCES. 33(5) |
| ISSN: | 1365-2982 |
| Popis: | Opioid-induced esophageal dysfunction (OIED) is a recognized complication of chronic opioid use. However, the impact of acute opioid administration on esophageal motility remains unclear.Opioid naïve patients with high-resolution manometry (HRM)480 min following esophagogastroduodenoscopy (EGD) (opioid-HRM) and a control group with HRM36 h prior to EGD between January 1, 2016, and November 10, 2018, from a single institution were identified. EGDs were performed exclusively with versed and fentanyl.One hundred and seventy-four patients were identified, with 83 (47.7%) opioid-HRM and 91 (52.3%) controls. Mean time from EGD to HRM was 229 (78-435) min. Baseline clinical features and HRM indications were similar between opioid-HRM and controls. Chicago classification v3.0 defined HRM findings were similar between groups. Major motility disorders as defined by the Chicago classification v3.0 occurred at a similar frequency among opioid-HRM and controls (27.7% vs. 36.3%, p = 0.23). Mean distal contractile integrity (DCI) was higher in opioid-HRM (1939.3 ± 1318.9 vs. 1792.2 ± 2062.3 mmHg∙cm∙s, p = 0.043), but maximum DCI, distal latency, and integrated relaxation pressure did not differ between groups. Subgroup analysis assessing time and dose dependency did not identify differences in individual manometric parameters and Chicago classification v3.0 diagnosis between patients with HRM240 min after EGD,240 min after EGD, ≥125 mcg of IV fentanyl,125 mcg IV fentanyl and controls.Same-day acute opioid administration did not affect HRM findings in opioid naïve patients. Studies assessing the pathophysiology of and duration-dependent relationship with opioids in OIED are needed. |
| Databáze: | OpenAIRE |
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