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Parenteral erythromycin for potential use to empty retained gastric contents encountered during upper gastrointestinal endoscopic procedures

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DOI: 10.4236/ojgas.2012.23025    4,607 Downloads   6,616 Views  

ABSTRACT

Background: Erythromycin, a prokinetic agent facilitates gastric emptying. We report our experience with the use of IV erythromycin for emptying retained gastric contents encountered during elective upper gastrointestinal endoscopy (UGIE) procedures in an effort to complete of the procedure on the same day. Patients and methods: This retrospective case series includes 15 patients who were found to have a signifycant amount of retained gastric contents while undergoing an UGIE procedure. After aborting the procedure, a repeat endoscopic examination was performed 30 - 120 minutes following administration of 250 - 500 mg erythromycin intravenously. Results: During repeat endoscopy, ten patients had complete emptying of the gastric contents, three patients had partial emptying and in two patients the amount of residual contents was largely unchanged. Both these patients were later found to have high grade mechanical gastric outlet obstruction. No anesthesia or procedure related complications were noted. Conclusion: Parenteral erythromycin can rapidly empty retained gastric contents encountered during UGIE procedures in a significant proportion of patients. Erythromycin can potentially be tried for safe completion of procedure on the same day.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Saied, N. , Chopra, A. and Agarwal, B. (2012) Parenteral erythromycin for potential use to empty retained gastric contents encountered during upper gastrointestinal endoscopic procedures. Open Journal of Gastroenterology, 2, 119-123. doi: 10.4236/ojgas.2012.23025.

References

[1] Warner, M.A., Warner, M.E. and Weber, J.G. (1993) Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology, 78, 56-62. doi:10.1097/00000542-199301000-00010
[2] American Society of Anesthesiologists Task Force on Preoperative Fasting (1999) Practice guidelines for pre-operative fasting and the use of pharmacologic agentsto reduce the risk of pulmonary aspiration: Application of healthy patients undergoing elective procedures. Anesthesiology, 90, 896-905. doi:10.1097/00000542-199903000-00034
[3] Hawkyard, C.V. and Koerner, R.J. (2007)The use of erythromycin as a gastrointestinal prokinetic agent in adult critical care: Benefits versus risks. Journal of Anti- microbial Chemotherapy, 59, 347-358. doi:10.1093/jac/dkl537
[4] Petring, O.U. and Blake, D.W. (1993) Gastric emptying in adults: An over-view related to anesthesia. Anaesthesia and Intensive Care, 21, 774-781.
[5] Soreide, E., Eriksson, L.I., Hirlekar, G., et al. (Task Force on Scandinavian Pre-operative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesi-ology and Intensive Care Medicine) (2005) Pre-operative fasting guidelines: An update. Acta Anaesthesiologica Scandinavica, 49, 1041-1047. doi:10.1111/j.1399-6576.2005.00781.x
[6] Urbain, J.L., Vantrappen, G., Janssens, J., et al. (1990) Intravenous erythromycin dramatically accelerates gastric emptying in gastroparesis diabeticum and normals and abolishes the emptying discrimination between solids and liquids. Journal of Nuclear Medicine, 31, 1490-1493.
[7] Berne, J.D., Norwood, S.H., McAuley, C.E., et al. (2002) Erythromycin reduces delayed gastric emptying in critically ill trauma patients: A randomized, controlled trial. Archives of Surgery, 37, 696-701.
[8] Frossard, J.L., Spahr, L., Queneau, P.E., Giostra, E., Burckhardt, B., Ory, G., De Saussure, P., Armenian, B., De Peyer, R. and Hadengue, A. (2002) Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: A randomized, controlled, double-blind trial. Gastroenterology, 123, 17-23. doi:10.1053/gast.2002.34230
[9] Carbonell, N., Pauwels, A., Serfaty, L., Boelle, P.Y., Becquemont, L. and Poupon, R. (2006) Erythromycin infusion prior to endoscopy for acute upper gastrointestinal bleeding: A randomized, controlled, double-blind trial. The American Journal of Gastroenterology, 101, 1211-1215. doi:10.1111/j.1572-0241.2006.00582.x
[10] Asai, T., Murao, K. and Shingu, K. (2000) Pre-operative oral erythromycin reduces residual gastric volume and acidity. British Journal of Anaesthesia, 85, 861-864. doi:10.1093/bja/85.6.861
[11] Kopp, V.J., Mayer, D.C. and Shaheen, N.J. (1997) Intra-venous erythromycin promotes gastric emptying prior to emergency anesthesia. Anesthesiology, 87, 703-705.

  
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