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Opioids prolong nuclear hepatobiliary imaging when given prior to scanning
David Barlas1, Donald Margouleff, Lisa Vignogna-Barlas
1Department of Emergency Medicine, North Shore University Hospital, New York University School of Medicine, Manhasset, New York 11030, USA.
The Journal of Emergency Medicine
|November 12, 2002
Summary
Opioid use before nuclear hepatobiliary imaging (NHI) can delay common bile duct visualization and prolong scan times. This finding is crucial for accurate interpretation of NHI studies in emergency departments.
Area of Science:
- Hepatobiliary Imaging
- Radiology
- Pharmacology
Background:
- Opioid administration can cause smooth muscle contraction.
- Distal common bile duct (CBD) contraction may impede tracer flow.
- This can mimic or obscure actual biliary obstruction on imaging.
Purpose of the Study:
- To investigate the impact of pre-procedural opioid administration on nuclear hepatobiliary imaging (NHI).
- To determine if opioids delay CBD visualization and prolong imaging duration.
- To assess the association between opioid use and delayed findings in NHI.
Main Methods:
- Retrospective review of 198 Emergency Department patients undergoing NHI.
- Exclusion of patients with confirmed pathologic CBD obstruction.
- Comparison of CBD visualization and imaging duration between opioid and non-opioid groups.
Main Results:
- Delayed CBD visualization occurred in 28.6% of patients who received opioids versus 12.0% who did not (p < 0.01).
- Delayed imaging sessions were more frequent in opioid recipients (77.8%) compared to non-recipients (53.5%) (p < 0.01).
- Morphine (RR 4.18) and any opioid (RR 2.38) significantly increased the risk of delayed visualization.
Conclusions:
- Opioid administration prior to NHI is associated with delayed common bile duct visualization.
- Opioids can lead to prolonged imaging sessions, potentially mimicking obstruction.
- Clinicians should consider pre-imaging opioid use when interpreting NHI studies.