Effectiveness of premedication with pronase for visualization of the mucosa during endoscopy: a double-blinded, multi-center, prospective, randomized study / 中华消化内镜杂志

ABSTRACT

Objective To assess the efficacy and safety of premedicaton with pronase before upper gastrointestinal endoscopy (UGI).Methods A total of 440 outpatients from 5 centers were randomly assigned to receive endoscopy with one of three premedications as followsdimethylpolysiloxane (DMPS) and pronase (group A,n =170) ; DMPS and sodium bicarbonate (group B,n =170) ; DMPS,pronase and sodium bicarbonate (group C,n =100).Six endoscopists,who were unaware of the premedication types,calculated the visibility scores (range,1 to 4) of the antrum,gastric body,and fundus.The sum of the scores from the three locations was defined as the total visibility score.Results With regards to routine white light endoscopy,the total visibility score of group C was significantly higher than that of group A (P =0.0001),and the score of group A was significantly higher than that of group B (P =0.0019).Concerning chromoendoscopy,the total visibility score of group C was significantly higher than that of group A (P =0.0054),and the score of group A was also significantly higher than that of group B (P ＜ 0.0001).Conclusion Combined application of pronase,dimethylpolysiloxane,and sodium bicarbonate before UGI endoscopy significantly improves endoscopic visualization.