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Mucolytic-antifoam solution for reduction of artifacts during endoscopic ultrasonography: a randomized controlled
A Yiengpruksawan1, C J Lightdale, H Gerdes
1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Abstract:
Gastric mucus and air bubbles are frequent sources of artifacts during endoscopic ultrasonography (EUS). To reduce these artifacts, we prepared a mucolytic-antifoam solution consisting of simethicone, acetylcysteine, and sodium bicarbonate and performed a prospective randomized and controlled trial comparing this solution (21 patients) to a placebo (22 patients) during EUS. Eight patients in the drug group received a perfect score for both mucolytic and antifoam effect compared with none in the placebo group (p less than 0.001). For overall rating, the drug group received a total of 10 excellents and 9 goods compared with 9 goods, 10 satisfactories, and 1 unacceptable in the placebo group (p less than 0.001). There were no complications associated with the solution. In conclusion, a mucolytic-antifoam solution improved endoscopic visualization and reduced artifacts during EUS study. Its routine use during EUS procedures is therefore recommended.
Insights
A new mucolytic-antifoam solution significantly reduced artifacts during endoscopic ultrasonography (EUS) procedures. This preparation, containing simethicone, acetylcysteine, and sodium bicarbonate, is recommended for routine EUS use.
Area of Science:
- Gastroenterology
- Medical Imaging
Background:
- Gastric mucus and air bubbles commonly cause artifacts in endoscopic ultrasonography (EUS).
- These artifacts can impair visualization and diagnostic accuracy during EUS examinations.
Purpose of the Study:
- To evaluate the efficacy of a novel mucolytic-antifoam solution in reducing artifacts during EUS.
- To compare the performance of the solution against a placebo in a prospective randomized controlled trial.
Main Methods:
- A prospective randomized controlled trial was conducted comparing a mucolytic-antifoam solution (simethicone, acetylcysteine, sodium bicarbonate) with a placebo.
- The study involved 21 patients receiving the solution and 22 patients receiving the placebo during EUS procedures.
- Artifact reduction was assessed by scoring mucolytic and antifoam effects, alongside an overall rating of visualization quality.
Main Results:
- The mucolytic-antifoam solution group showed significantly improved mucolytic and antifoam effects, with 8 patients achieving perfect scores (p < 0.001).
- Overall ratings were superior in the solution group (10 excellent, 9 good) compared to the placebo group (9 good, 10 satisfactory, 1 unacceptable; p < 0.001).
- No complications were reported with the use of the mucolytic-antifoam solution.
Conclusions:
- The developed mucolytic-antifoam solution effectively reduces artifacts and enhances endoscopic visualization in EUS.
- The solution demonstrated a significant improvement in image quality and patient outcomes.
- Routine implementation of this mucolytic-antifoam solution during EUS procedures is recommended for better diagnostic outcomes.