The effectiveness of oral Phloroglucin as premedication fo non sedative endoscopy

Abstract

Background/Aims: Antispasmotic agents are commonly injected before esophagogastroduodenoscopy (EGD) to inhibit gastrointestinal peristalsis. If antispasmotics can be taken orally, that may be convenient in patients who are undergoing non-sedative EGD. This study aimed to evaluate the effectiveness of oral Phloroglucin (Flospan®) as premedication for non-sedative EGD. Methods: A Prospective, double-blinded, placebo-controlled, randomized controlled trial was conducted at a single tertiary hospital. Subjects who scheduled to undergo non-sedative EGD were randomly assigned to receive oral Phloroglucin (Flospan®) or placebo at 10 minutes before EGD. The degree of peristaltic movement was evaluated at the beginning and the end of the procedure by independent investigators. We recorded adverse events, taste of drug, willingness to take this premedication at the next examination and the difficulty of intragastric observation which were assessed by endoscopists who performed the procedure. Results: Overall, 140 subjects were included in the study (Phloroglucin 70, placebo 70, age mean±SD, 66.31±9.37, male 47.8%). The degree of peristalsis in Phloroglucin group was significantly lower compared with that of placebo at the beginning of the procedure (p=0.02) and tended to be lower at the end of the procedure, although it did not show statistical significance (p=0.064). The difficulty of intragastric observation was significantly lower in Phloroglucin group compared with placebo at the both time period (beginning of the procedure: p=0.002, end of the procedure: p=0.009). Both groups showed comparable adverse events, taste of the drug and willingness to take this premedication at the next examination. Conclusions: Oral Phloroglucin(Flospan®) significantly suppress gastrointestinal peristalsis during non-sedative EGD compared with placebo.