Pre-endoscopic medication. A randomized double-blind trial of atropine and meperidine as a supplement to diazepam.

The effects of an intramuscular injection of atropine (0.6 mg) and meperidine (1 mg/kg body weight) 30 min before topical benzocaine and intravenous diazepam administration were compared with those of a control group that received only benzocaine and intravenous diazepam in a randomized double-blind controlled trial of premedication for upper gastrointestinal endoscopy in 100 consecutive patients. Atropine and meperidine decreased the amount of salivation and gastric secretion (p less than 0.001 and p less than 0.001, respectively) and increased the period of sedation (p less than 0.001). The patients' and examiners' evaluation of the procedure was the same with either premedication regimen. Neither regimen affected the success rate of the endoscopy. Regardless of the regimen used, every patient who underwent endoscopy stated that they would consent to another examination, if necessary. Patients judged before endoscopy to be most apprehensive tolerated the procedure least, and those judged to be least apprehensive tolerated the procedure best, irrespective of premedication. The addition of meperidine and atropine to a premedication regimen of diazepam and topical benzocaine does not appear to be beneficial.