Investigation of nausea-related adverse events associated with pethidine hydrochloride administration during esophagogastroduodenoscopy

Abstract

Background and Objectives: Although the efficacy of pethidine hydrochloride (pethidine) alone during upper gastrointestinal endoscopy has been demonstrated, it may cause nausea as an adverse event. This study investigated the factors causing nausea during pethidine administration.

Methods: We investigated participants who received pethidine alone during esophagogastroduodenoscopic screening. Nausea-related symptoms were defined as the presence of one or more of the following: nausea, vomiting, dizziness, and decreased blood pressure. Factors contributing to longer recovery times due to nausea-related side effects were analyzed using univariate and logistic regression analyses. The explanatory variables used in the logistic regression analysis were age, sex, alcohol consumption, smoking status, butylscopolamine use, systolic blood pressure before the examination, degree of discomfort during the examination, and pethidine dose per body weight. The optimal pethidine dose was calculated using a receiver operating characteristic (ROC) curve.

Results: A total of 3,004 participants were analyzed. Nausea-related symptoms occurred in 142 participants (4.7%). In the logistic regression analysis, factors that increased nausea-related symptoms were non-drinking, non-smoking, low systolic blood pressure before the examination, high examination discomfort, butylscopolamine non-use, and increased pethidine dose per body weight. The optimal cut-off pethidine dose per body weight based on the ROC curve was 0.513 mg/kg.

Conclusion: To avoid nausea-related side effects, it is important to adjust the pethidine dose according to body weight. Additionally, being aware of factors related to the occurrence of nausea-related side effects and adjusting the dose accordingly may be beneficial.