Epinephrine in the submucosal injectate of no benefit for colorectal Endoscopic mucosal resection: study
Using epinephrine in the submucosal injectate for Endoscopic mucosal resection increases postprocedural pain, which prolongs recovery time and may also cause diagnostic confusion, suggests a recent study published in the Gastrointestinal Endoscopy.
Endoscopic mucosal resection (EMR) is an outpatient procedure that lets physicians remove tumours just beneath the gastrointestinal (GI) wall without surgery. Using an endoscope — a flexible, tube-like instrument — our gastroenterologists (physicians who specialize in treating the GI tract) can see inside the body with a high degree of detail. At the same time, they can remove growths such as upper GI or colon polyps that might otherwise require surgery.
EMR is the first-line therapy for colorectal laterally spreading lesions. Some colonoscopists include epinephrine in the submucosal injectate, which we observed increased post-procedure discomfort. Our aim was to determine whether the inclusion of epinephrine in the submucosal injectate increases postprocedure pain after EMR.
Researchers performed a randomized, controlled, double-blind trial comparing epinephrine in submucosal injectate versus injectate alone for abdominal pain at 30 and 60 minutes after EMR.
The Results of the study are:
The mean polyp diameter in both arms was >40 mm. There were no differences in procedure times or amounts of fluid injected. Mean pain was higher on a visual analog scale in the epinephrine group at 30 minutes (47 vs 14, P = .022) and at 60 minutes (44 vs 13, P = .035). Recovery room stay was longer in the epinephrine group (68 vs 53 minutes, P = .034).
Thus, the researchers concluded that epinephrine in the submucosal injectate for EMR increases postprocedural pain, which could cause diagnostic confusion and prolong observation time in the recovery area.
Reference:
Impact of including epinephrine in the submucosal injectate for colorectal EMR on postprocedural pain: a randomized controlled trial by Douglas K. Rex, et al. published in the Gastrointestinal Endoscopy.
https://www.giejournal.org/article/S0016-5107(21)01874-5/fulltext#
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.