The Application Value Of Peppermint Oil During Colonoscopy

Objective:Colonoscopy is one of the most important and reliable methods for the diagnosis of colorectal diseases,but colonic spasm often hinders the progress of colonoscopy,prolongs the time of examination,increases the patients' discomfort,and affects the accuracy of colonoscopy and the detection of lesions.Therefore,patients often get antispasmodics to inhibit colonic smooth muscle contraction before colonoscopy.Antispasmodics such as anticholinergic drugs and glucagon,may cause some side effects,and they have many contraindications.Peppermint oil can relax the smooth muscle of digestive tract,and it can be used as an antispasmodic during gastroscopy,colonoscopy,ERCP and other examinations.However,it is rarely used in clinical practice.The aims of this study were to assess the spasmolytic effect of peppermint oil,the influence on the detection of polyps and the patients' discomfort after treatment,as well as to explore the application value of peppermint oil during colonoscopy.Methods:A total of 68 patients who received colonoscopy in Tianjin Medical University General Hospital between May 2018 and December 2018 were randomly divided into the experimental group(n=34)and the control group(n=34).The 20 ml 0.8% peppermint oil was sprayed onto the colonic mucosa in the experimental group via the biopsy channel of the colonoscope,while the control group was sprayed with 20 ml normal saline.The degree of spasm and the detection of polyps were evaluated and recorded pre-dose,30 s post-dose and 60 s post-dose.The subjective feeling of patients and the adverse reactions during the operation were also recorded after the examination.Specimens were sent for pathologic diagnosis.The outcome measures,including the efficacy rate of spasmolytic effect,the proportion of colonic peristaltic grade 0 and grade 1,the mean colonic peristaltic score,the detection of polyps,the patients' discomfort and the adverse reactions during endoscopic operation were compared between the two groups by SPSS statistical software.Results:1.The efficacy rate of antispasmodic effect 30 s post-dose in the experimental group was significantly higher than that in the control group(45.8% vs14.3%,P < 0.05).The efficacy rate of antispasmodic effect 60 s post-dose in the experimental group was significantly higher than that in the control group(66.7% vs 19.0%,P =0.001).2.The proportion of colonic peristaltic grade 0 and grade 1 was 58.8% pre-dose and 76.5% 30 s post-dose in the experimental group,64.7% pre-dose and 67.7% 30 s post-dose in the control group,respectively,with no significant difference(P > 0.05).And compared with the control group 60 s post-dose,the proportion of colonic peristaltic grade 0 and grade 1 was significantly increased(88.2% vs 67.7%,P < 0.05).3.The mean colonic peristalsis score in the experimental group after treatment was obviously decreased compared with that before treatment(0.90±0.67 vs 1.38±0.64,P<0.001).The mean colonic peristalsis score in the experimental group after treatment was also significantly lower than that in the control group(0.90±0.67 vs 1.29±0.62,P<0.001).And the experimental group showed a greater decrease than the control group(0.74±0.536 vs 0.04±0.207,P<0.001)in the mean difference which is the value compared between pre-dose and post-dose scores.4.In terms of the detection of polyps,there were no statistically significant differences between the two groups in the number of polyps detected,the number of polyps per patient,the size of polyps and the pathology of polyps(P > 0.05).While the number of polyps per patient in the experimental group showed a general uptrend.5.Compared with the control group,the patients' discomfort during colonoscopy in the experimental group was milder(P < 0.05).6.No adverse drug reactions occurred in either groups.Conclusions:In our study,directly spraying 0.8% peppermint oil onto the colonic mucosa can effectively decrease colonic spasm which is related to time and relieve the patient's discomfort during colonoscopy.It is easy to use,with no obvious side effects,while it can't improve the detection of polyps.The intraluminal application of peppermint oil might be a safe,effective and convenient alternative during colonoscopy.