Experience with droperidol during sphincter of Oddi manometry

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Abstract

Background: Sphincter of Oddi manometry (SOM) is frequently performed in patients with disabling pancreatobiliary pain who require large doses of narcotic analgesics, making conscious sedation and performance of SOM technically more difficult. Droperidol, a short-acting butyrophenone, is frequently used in these and other patients who prove difficult to sedate with diazepam and meperidine alone. The aim of this study was to determine the effect of droperidol on the biliary and pancreatic sphincters. Methods: 16 pts (3 male, 13 female) with a mean age of 43 years (range 24-74) were prospectively evaluated by SOM in the conventional retrograde fashion. Indications for SOM included pancreatobiliary pain (13 patients) and idiopathic pancreatitis (3 patients). Manometry (1-3 station pull throughs) was initially performed with intravenous diazepam alone (dose 20-40 mg IV). The manometry was repeated 5 minutes after droperidol (1.25-2.5 mg IV) was administered. Results: Effect of Droperidol on the Biliary and Pancreatic Sphincter Biliary (n=7) Papcreatic (n=9) pre post pre post Basal sphincter pressure- 21.6 ± 15.9 20.9 ± 14.2* 39.3 ± 20.8 44.4 ± 30.5* Phasic pressure- 114.4 ± 27.6 115.6 ± 25.3* 109.6 ± 25.4 94.9 ± 18.9* Phasic duration (sec) 5.6 ± 0.9 4.9 ± 0.9* 5.8 ± 1.3 5.2 ± 0.9* Phasic frequency (#/min) 3.0 ± 1.4 3.7 ± 1.5* 4.6 ± 2.0 4.5 ± 2.1* Data expressed as mean ± SD; + mmHg; *pre vs post: P > .05. Concordance (normal vs abnormal) between the basal sphincter pressure before and after droperidol was seen in 15 of 16 pts (94%). Summary: In this small study, only 1/16 patients would have had a change in management (sphincterotomy vs no sphincterotomy) with use of droperidol for SOM. This preliminary data indicates that the biliary and pancreatic basal sphincter pressures, phasic pressure, phasic duration and phasic frequency were not significantly altered by droperidol. Conclusion: A larger series is needed before droperidol can be recommended for routine use with SOM. This study is on-going.

Original languageEnglish (US)
Pages (from-to)AB49
JournalGastrointestinal endoscopy
Volume47
Issue number4
StatePublished - Dec 1 1998

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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