Fogel Evan L, Sherman Stuart, Bucksot Lois, Shelly LeeAnn, Lehman Glen A
Indiana University Medical Center, Indianapolis, Indiana, USA.
Gastrointest Endosc. 2003 Oct;58(4):488-92. doi: 10.1067/s0016-5107(03)01541-4.
Performance of sphincter of Oddi manometry at ERCP is technically demanding and requires that the patient be well sedated. Droperidol is frequently administered when adequate sedation cannot be achieved with a benzodiazepine and meperidine. This study examined the effects of droperidol on the biliary and pancreatic sphincters.
A total of 31 patients were prospectively evaluated by sphincter of Oddi manometry in the conventional retrograde fashion. Manometry was initially performed with intravenous administration of diazepam alone, diazepam plus meperidine or midazolam plus meperidine. Manometry was then repeated 5 minutes after droperidol was administered.
The basal pressure of the biliary sphincter and of the pancreatic sphincter were not significantly altered by droperidol. Concordance (normal vs. abnormal) between the basal sphincter pressure before and after droperidol was seen in 30 patients (97%). Droperidol also did not lead to a difference in phasic wave amplitude, duration, or frequency. Thirteen manometry tracings (42%) were judged as being qualitatively better after droperidol, whereas two (6.5%; </= p 0.001) were qualitatively better before droperidol administration.
Droperidol does not significantly affect sphincter of Oddi manometric parameters. It appears that it can be added to the armamentarium of agents needed for performance of sphincter of Oddi manometry. However, further study is needed to determine whether recent safety concerns with droperidol use are valid.
在内镜逆行胰胆管造影术（ERCP）中进行Oddi括约肌测压技术要求较高，且需要患者充分镇静。当使用苯二氮䓬类药物和哌替啶无法实现充分镇静时，常常会使用氟哌利多。本研究探讨了氟哌利多对胆管和胰管括约肌的影响。
采用传统逆行方式对31例患者进行了前瞻性Oddi括约肌测压评估。测压最初单独静脉注射地西泮、地西泮加哌替啶或咪达唑仑加哌替啶。在注射氟哌利多5分钟后重复测压。
氟哌利多未显著改变胆管括约肌和胰管括约肌的基础压力。30例患者（97%）在注射氟哌利多前后括约肌基础压力的一致性（正常与异常）情况良好。氟哌利多也未导致相波幅度、持续时间或频率出现差异。13份测压记录（42%）在注射氟哌利多后质量上被判定更好，而两份（6.5%；p≤0.001）在注射氟哌利多前质量更好。
氟哌利多不会显著影响Oddi括约肌测压参数。似乎它可以添加到进行Oddi括约肌测压所需的药物储备中。然而，需要进一步研究以确定近期对使用氟哌利多的安全性担忧是否合理。
