Optimal administration time of indomethacin in preventing hyperamylasemia after ERCP and reducing pain degree / 中华胰腺病杂志

ABSTRACT

Objective:To observe the effects of different indomethacin anal suppository administration time on increased serum amylase, pancreatitis onset and the degree of pain after ERCP, and explore the optimal administration time.Methods:A total of 240 patients with cholangiopathy who were admitted and planned to be treated by ERCP in Department of General Surgery of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2018 to May 2019 were randomly divided into 6 groups using random number method with 40 patients in each group, who were given 100 mg intrarectal indomethacin at 120 min, 60 min, 30 min before ERCP and 30 min, 60 min, 120 min after ERCP. The incidence of post-ERCP hyperamylasemia, post-ERCP pancreatitis (PEP) and the degree of postoperative pain were compared among different groups.Results:The increased times of blood amylase level and the incidence of hyperamylasemia and PEP at 24 hour, and postoperative 3 h and 24 h pain scores in preoperative medication group were significantly lower than those in postoperative medication group [(4.2±1.9) vs(4.7±2.1), 36.7% vs 46.7%, 19.2% vs 24.2%, (5.9±2.1) vs(6.4±1.4) and(3.8±1.7) vs (4.3±1.4)score, all P<0.05), and the amylase increased times (2.5±1.2), the incidence of hyperamylasemia and PEP[(27.5%(11/40) vs 12.5%(5/40), and postoperative pain score (3.0±1.2) were the least in preoperative 30 min medication group. Conclusions:Indomethacin anal suppository can reduce the incidence of postoperative hyperamylasemia and PEP and mitigate the pain degree after ERCP, and indomethacin given 30 minutes before ERCP may obtain the best preventive effect.