The effect of using simethicone with or without N-acetylcysteine before gastroscopy: A meta-analysis and systemic review

@article{Li2019TheEO,
  title={The effect of using simethicone with or without N-acetylcysteine before gastroscopy: A meta-analysis and systemic review},
  author={Yuanfa Li and Fangjuan Du and Dou Fu},
  journal={Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association},
  year={2019},
  volume={25},
  pages={218 - 228}
}
  • Yuanfa LiFangjuan DuD. Fu
  • Published 1 July 2019
  • Medicine
  • Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association
Background/Aim: To assess the efficacy and safety of simethicone with or without N-acetylcysteine (NAC) as premedications before gastroscopy. Materials and Methods: We searched EMBASE, PubMed, Cochrane library and Web of Science database for randomized clinical controlled trials regarding simethicone ± NAC as oral drinking agents before gastroscopy. Statistical software RevMan5.3 was used for statistical analysis. Results: Ten randomized clinical trials that fulfilled the inclusion criteria… 

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References

SHOWING 1-10 OF 43 REFERENCES

Premedication with simethicone and N-acetylcysteine in improving visibility during upper endoscopy: a double-blind randomized trial.

Premedication with simethicone resulted in better mucosal visibility and might improve diagnostic yield, and should be considered for standard practice.

Improving the mucosal visualization at gastroscopy: a systematic review and meta-analysis of randomized, controlled trials reporting the role of Simethicone ± N-acetylcysteine.

The findings of current study on 1,099 patients successfully demonstrate that the pre-procedure oral administration of Simethicone ± N-acetylcysteine improves mucosal visualization and mucosal visualize score during OGD.

A randomized controlled trial of pre-procedure simethicone and N-acetylcysteine to improve mucosal visibility during gastroscopy – NICEVIS

A pre-procedure drink containing simethicone and NAC significantly improves mucosal visibility during gastroscopy and reduces the need for flushes during the procedure.

Efficacy of premedication with activated Dimethicone or N-acetylcysteine in improving visibility during upper endoscopy.

Premedication with activated Dimethicone 20 min prior to the upper endoscopy leads to the best visibility, and N-acetylcysteine does not improve visualization by itself.

Premedication with pronase or N-acetylcysteine improves visibility during gastroendoscopy: an endoscopist-blinded, prospective, randomized study.

Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach and neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.

The add-on N-acetylcysteine is more effective than dimethicone alone to eliminate mucus during narrow-band imaging endoscopy: a double-blind, randomized controlled trial

Considering the safety profile of NAC, decreasing the number of water flushes for optimal vision and unavailability of pronase in some areas, the authors suggest the use of add-on NAC to eliminate mucus during NBI endoscopy.

Systematic review and meta-analysis of randomized controlled trials of Simethicone for gastrointestinal endoscopic visibility

Supplemental use of Simethicone before endoscopy improves the small bowel visualization quality (SBVQ), especially for patients who received no purgative, but does not affect the CE completion rate.

Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study

Whether the use of a premedication solution containing the mucolytic agent N-acetylcysteine and the surfactant simethicone improves mucosal visualization within a UK diagnostic gastroscopy service is determined.

Efficacy of small-volume simethicone given at least 30 min before gastroscopy

With a premedication time of at least 30 min, 5 mL simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten gastroscopy time.