Application of different doses of simethicone in upper endoscopy for children:A randomized controlled study

FANG Hao-ran; LI Zhong-yue; ZHANG Hui-hua; HU Hua-jian; YU Zhong-su; LUO Ying; LIU Bo

doi:10.19538/j.ek2024040611

Abstract：Objective To compare the efficacy of different doses of simethicone on operation of upper endoscopy for children.Methods Patients aged ≥2 years old who received upper endoscopy in Children's Hospital of Chongqing Medical University from Mar.1 to Dec.31 of 2022 were included in this study.Study subjects were randomly assigned to 4 groups.Group A received 20 mL water before examination as control,Group B received 40 mg simethicone,Group C received 100 mg simethicone,and Group D received 200 mg simethicone.Visibility of upper endoscopy,procedure time,cases requiring endoscopic flushing,and cases of oxygen desaturation were compared and analyzed.Results A total of 800 pediatric patients were included in this study,200 patients in each group.There were no significant differences regarding gender composition and mean age in each group(x2=0.981,H=2.239,P＞0.05).The proportion of adequate visibility in Group A,Group B,Group C and Group D was 38.5％、66％、80.5％and 78.5％,respectively.The proportion of adequate visibility in group A was significantly lower than that in the other groups(x2AB=30.331,x2AC=73.203,x2AD=65.905,all P＜0.05).The proportion of adequate visibility in Group B was significantly lower than that in Group C and Group D(x2BC=10.730,x2BD=7.793,all P＜0.05).No significant differences were detected regarding proportion of adequate visibility between Group C and Group D(P＞0.05).Procedure time in group B[(192.0± 53.6)s],group C[(169.0±45.8)s],and group D[(169.8±46.6)s]was significant shorter than that in group A[(221.2±58.8)](ZAB=-4.412,ZAC=-8.373,ZAD=-8.023,all P＜0.05).Procedure time in Group C and Group D was significant shorter than that in Group B(ZBC=-4.5,ZBD=-4.418,all P＜0.05).No significant differences were detected regarding procedure time between Group C and Group D(P＞0.05).Cases requiring endoscopic flushing in Group A(76 cases)were significantly higher than those in Group B(24 cases),Group C(10 cases),and Group D(11 cases)(x2 AB=36.053,x2AC=63.394,x2AD=62.062,all P＜0.05).Cases requiring endoscopic flushing in Group B were significantly higher than those in Group C and Group D(x2BC=6.076,x2BD=5.292,all P＜0.05).No significant differences were detected regarding cases requiring endoscopic flushing between Group C and Group D(P＞0.05).There were no significant differences regarding cases of oxygen desaturation among the 4 groups(P＞0.05).Conclusion Premedication of simethicone can significantly improve the visibility during upper endoscopy in children,and 100 mg simethicone is enough to achieve an ideal cleaning effect.