Sedatives reduce human gastric slow-wave amplitude, assessed by a multicenter study of endoscopic gastric mapping
- 1The University of Auckland
Abstract
BackgroundGastrointestinal (GI) motility disorders are prevalent, impose a significant burden, and are associated with disrupted spatial propagation of bioelectrical gastric slow waves. High-resolution endoscopic gastric mapping (EGM) is an emerging minimally invasive technique for imaging gastric electrical activity; however, EGM is performed alongside standard gastroscopy and requires procedural sedation, which may interact with gastric electrical activity, distorting clinical insights. This study explored the influence of procedural sedation on EGM-recorded slow-wave activity.
MethodsEGM was performed for [~]7 min in 32 patients undergoing upper GI endoscopy at two New Zealand hospitals. Endoscopists administered procedural sedation (fentanyl and midazolam) according to best clinical practice. The relationship between slow-wave amplitude and patient characteristics was then investigated using a variety of statistical techniques.
Key ResultsGastric slow waves were detected in 30 of 32 patients who underwent EGM. Symptom scores and demographic measures were comparable between sites. Fentanyl (A, 93.4 {+/-} 13.7 g vs B, 137.5 {+/-} 33.7 g, p[≤]0.001) and midazolam (A, 5.0 {+/-} 0.9 mg vs B, 7.4 {+/-} 1.6 mg, p[≤]0.001) doses were higher at Hospital B than Hospital A. Correspondingly, slow-wave amplitudes were lower at Hospital B than Hospital A (A, 2.33 {+/-} 1.61 mV vs B, 0.86 {+/-} 1.01 mV, p=0.004). All other slow-wave metrics were consistent between hospitals. Combined sedative dose was negatively correlated with slow-wave amplitude (p=0.037).
Conclusions & InferencesHigher procedural sedative doses are associated with lower-amplitude gastric slow-waves. Procedural sedation dose and opiate administration should be carefully considered when interpreting GI electrophysiology measurements.
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BibTeX
@misc{tremain2026sedatives,
title = {{Sedatives reduce human gastric slow-wave amplitude, assessed by a multicenter study of endoscopic gastric mapping}},
author = {P. Tremain and J. Dowrick and C.-H. A. Chan and D. Rowbotham and G. Lim and G. O'Grady and L. K. Cheng and J. Mckeage and T. R. Angeli-Gordon},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.15.26365429},
url = {https://www.medrxiv.org/content/10.64898/2026.10.15.26365429v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Sedatives reduce human gastric slow-wave amplitude, assessed by a multicenter study of endoscopic gastric mapping
AU - P. Tremain
AU - J. Dowrick
AU - C.-H. A. Chan
AU - D. Rowbotham
AU - G. Lim
AU - G. O'Grady
AU - L. K. Cheng
AU - J. Mckeage
AU - T. R. Angeli-Gordon
PY - 2026
DA - 2026/10/15
PB - medRxiv
DO - 10.64898/2026.10.15.26365429
UR - https://www.medrxiv.org/content/10.64898/2026.10.15.26365429v1
AB - BackgroundGastrointestinal (GI) motility disorders are prevalent, impose a significant burden, and are associated with disrupted spatial propagation of bioelectrical gastric slow waves. High-resolution endoscopic gastric mapping (EGM) is an emerging minimally invasive technique for imaging gastric electrical activity; however, EGM is performed alongside standard gastroscopy and requires procedural sedation, which may interact with gastric electrical activity, distorting clinical insights. This study explored the influence of procedural sedation on EGM-recorded slow-wave activity. MethodsEGM was performed for [~]7 min in 32 patients undergoing upper GI endoscopy at two New Zealand hospitals. Endoscopists administered procedural sedation (fentanyl and midazolam) according to best clinical practice. The relationship between slow-wave amplitude and patient characteristics was then investigated using a variety of statistical techniques. Key ResultsGastric slow waves were detected in 30 of 32 patients who underwent EGM. Symptom scores and demographic measures were comparable between sites. Fentanyl (A, 93.4 {+/-} 13.7 g vs B, 137.5 {+/-} 33.7 g, p[≤]0.001) and midazolam (A, 5.0 {+/-} 0.9 mg vs B, 7.4 {+/-} 1.6 mg, p[≤]0.001) doses were higher at Hospital B than Hospital A. Correspondingly, slow-wave amplitudes were lower at Hospital B than Hospital A (A, 2.33 {+/-} 1.61 mV vs B, 0.86 {+/-} 1.01 mV, p=0.004). All other slow-wave metrics were consistent between hospitals. Combined sedative dose was negatively correlated with slow-wave amplitude (p=0.037). Conclusions & InferencesHigher procedural sedative doses are associated with lower-amplitude gastric slow-waves. Procedural sedation dose and opiate administration should be carefully considered when interpreting GI electrophysiology measurements.
ER -