*EMBARGOED All research presented at the World Congress of Gastroenterology at ACG2017 is strictly embargoed until Monday, October 16, 2017, at 8:00 am EDT.

Salman Nusrat, MD

Oral 17 Use of Diphenhydramine as an Adjunctive Sedative for Colonoscopy in Patients on Chronic Opioids: A Randomized Controlled Trial

Author Insight from Salman Nusrat, MD, University of Oklahoma Health Sciences Center

What’s new here and important for clinicians?

Chronic opioid use is a well-recognized predictor of poor sedation. There has been a dramatic increase in the use of opioid pain medication in the last few decades. The increasing use of opioids in the general population and the associated cross-tolerance with conventional sedatives can lead to an increased dose requirement for sedatives used during endoscopic procedures. Our randomized, double-blind, placebo-controlled trial examined the role of diphenhydramine as an adjunct sedative in patient on chronic opioids. Our results showed that though the use of diphenhydramine did not decrease the dose of conventional sedative used, it did improve the quality of sedation as rated by the patient, nurses and the physicians.

What do patients need to know?

Patient tolerance is important for successful and safe completion of colonoscopy, and results in increased compliance and willingness to undergo repeat procedure. At times, adequate sedation cannot be achieved. Chronic opioid use because of cross-tolerance with commonly used sedatives is a risk factor for poor sedation. Our results showed that use of diphenhydramine in addition to conventional sedatives decreases pain and improves quality of sedation during colonoscopy.

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Author Contact
Salman Nusrat, MD, University of Oklahoma Health Sciences Center

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