Clinical Endoscopy

Necessity of pharyngeal anesthesia during transoral gastrointestinal endoscopy: a randomized clinical trial: Tomoyuki Hayashi, Yoshiro Asahina, Yasuhito Takeda, Masaki Miyazawa, Hajime Takatori, Hidenori Kido, Jun Seishima, Noriho Iida, Kazuya Kitamura, Takeshi Terashima, Sakae Miyagi, Tadashi Toyama, Eishiro Mizukoshi, Taro Yamashita; Clin Endosc 2023;56(5):594-603. Published online April 12, 2023; DOI: https://doi.org/10.5946/ce.2022.182

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation.
Methods
This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA– groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA– group in terms of the pharyngeal observation success rate.
Results
The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA–) groups were 84.0% and 72.0%, respectively. The PA– group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0–10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA– group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups.
Conclusions
Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.

3,103 View
102 Download

Bispectral index-guided propofol sedation during endoscopic ultrasonography: Ayana Okamoto, Ken Kamata, Takeshi Miyata, Tomoe Yoshikawa, Rei Ishikawa, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Kentaro Yamao, Mamoru Takenaka, Yasutaka Chiba, Toshiharu Sakurai, Naoshi Nishida, Masayuki Kitano, Masatoshi Kudo; Clin Endosc 2022;55(4):558-563. Published online July 12, 2022; DOI: https://doi.org/10.5946/ce.2022.001

Background
/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS).
Methods
This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room.
Results
The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001).
Conclusions
During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.

Citations

Citations to this article as recorded by

General anesthesia and/or deep hypnotic state in propofol-based conscious sedation for endoscopy
Halim Bou Daher, Ali El Mokahal, Mohamad Ali Ibrahim, Rana Yamout, Nour Hochaimi, Chakib Ayoub, Yasser H. Shaib, Ala I. Sharara
iGIE.2024; 3(2): 286. CrossRef
EEG bispectral index sensor guidance improves accuracy and safety of procedural sedation
A. Oh, N. Karim, A. Pitt, S. Hodgetts, D.W. Edwards, D. Mullan, H-U. Laasch
Clinical Radiology.2024;[Epub] CrossRef
Advances in Analgosedation and Periprocedural Care for Gastrointestinal Endoscopy
Sonja Skiljic, Dino Budrovac, Ana Cicvaric, Nenad Neskovic, Slavica Kvolik
Life.2023; 13(2): 473. CrossRef
Clinical and economic value of bispectral index monitoring for adequate endoscopic sedation
Se Woo Park
Clinical Endoscopy.2022; 55(4): 518. CrossRef
Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report
Jaesang Lee, Hosik Moon, Sungjin Hong, Jinyoung Chon, Hyejin Kwon, Hunwoo Park, Jiyung Lee
Medicina.2022; 59(1): 65. CrossRef

3,879 View
149 Download
5 Web of Science
5 Crossref

Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam: Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang, the Committees of Quality Management and Conscious Sedation of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2022;55(2):234-239. Published online October 12, 2021; DOI: https://doi.org/10.5946/ce.2021.126

Abstract PDF PubReader ePub

Background
/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxical reactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients who previously experienced paradoxical reactions.
Methods
This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions to midazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation) or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction.
Results
A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II (n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did not differ between groups.
Conclusions
Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam was readministered.

Citations

Citations to this article as recorded by

Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clinical Endoscopy.2024; 57(4): 476. CrossRef
The effective dose of butorphanol tartrate in patients of different ages undergoing painless gastroscopy
Yaorui Sun, Shujiao Liu, Wenli Si, Quanyi Zhang, Fei Yu, Ming Su, Chao Sun
Journal of International Medical Research.2024;[Epub] CrossRef
Efficacy and safety of remimazolam-based sedation for intensive care unit patients undergoing upper gastrointestinal endoscopy: a cohort study
Yuan-rui Zhao, Ke-sheng Huang, Guo Hou, Lan Yao, Li-ping Lu, Song Xu, Ying-tao Lian, Zhun Yao, Zhui Yu
World Journal of Emergency Medicine.2023; 14(1): 31. CrossRef
Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method
Yuling Zheng, Yafei Xu, Bixin Huang, Ying Mai, Yiwen Zhang, Zhongqi Zhang
Frontiers in Pharmacology.2022;[Epub] CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

4,550 View
281 Download
6 Web of Science
5 Crossref

Risk Factors for Prolonged Hospital Stay after Endoscopy: Toshihiro Nishizawa, Shuntaro Yoshida, Osamu Toyoshima, Tatsuya Matsuno, Masataka Irokawa, Toru Arano, Hirotoshi Ebinuma, Hidekazu Suzuki, Takanori Kanai, Kazuhiko Koike; Clin Endosc 2021;54(6):851-856. Published online March 16, 2021; DOI: https://doi.org/10.5946/ce.2020.292

Abstract PDF PubReader ePub

Background
/Aims: The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unit is desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay among outpatients.
Methods
We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at the Toyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depression during endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100 minutes) were identified using multiple logistic regression analysis.
Results
We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested without sedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and non-sedation group was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI, 1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results for colonoscopy.
Conclusions
Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.

Citations

Citations to this article as recorded by

Timing of Endoscopic Intervention for Esophageal Food Impaction and Its Impact on Patient Outcomes
Mark S. Obri, Momin Samad, Suhib Alhaj, Ammad Chaudhary, Sheema Rehman, M. Ramzi Almajed, Courtney Rose, Lonni Schultz, Kevin Harris, Suraj Suresh
Digestive Diseases and Sciences.2024;[Epub] CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef
TXI (Texture and Color Enhancement Imaging) for Serrated Colorectal Lesions
Toshihiro Nishizawa, Osamu Toyoshima, Shuntaro Yoshida, Chie Uekura, Ken Kurokawa, Munkhbayar Munkhjargal, Miho Obata, Tomoharu Yamada, Mitsuhiro Fujishiro, Hirotoshi Ebinuma, Hidekazu Suzuki
Journal of Clinical Medicine.2021; 11(1): 119. CrossRef

3,892 View
101 Download
3 Web of Science
3 Crossref

Comparison of Fentanyl versus Meperidine in Combination with Midazolam for Sedative Colonoscopy in Korea: Gwan Woo Hong, Jun Kyu Lee, Jung Hyeon Lee, Ji Hun Bong, Sung Hun Choi, Hyeki Cho, Ji Hyung Nam, Dong Kee Jang, Hyoun Woo Kang, Jae Hak Kim, Yun Jeong Lim, Moon Soo Koh, Jin Ho Lee; Clin Endosc 2020;53(5):562-567. Published online July 3, 2020; DOI: https://doi.org/10.5946/ce.2020.022

Abstract PDF PubReader ePub

Background
/Aims: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy.
Methods
A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as the primary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes.
Results
A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantly more rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min, p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001), but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal time and adenoma detection rate between the two groups.
Conclusions
The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.

Citations

Citations to this article as recorded by

Efficacy and safety of EBUS‐TBNA under conscious sedation with meperidine and midazolam
Roberto Piro, Eleonora Casalini, Matteo Fontana, Carla Galeone, Patrizia Ruggiero, Sofia Taddei, Giulia Ghidoni, Giulia Patricelli, Nicola Facciolongo
Thoracic Cancer.2022; 13(4): 533. CrossRef
Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam
Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2022; 55(2): 234. CrossRef
Efficacy of Analgesic Propofol/Esketamine and Propofol/Fentanyl for Painless Induced Abortion: A Randomized Clinical Trial
Naixing Xin, Wei Yan, Shuangfen Jin, Min Tang
BioMed Research International.2022; 2022: 1. CrossRef
Endoscopist-Driven Sedation Practices in South Korea: Re-evaluation Considering the Nationwide Survey in 2019
Seon-Young Park, Jun Kyu Lee, Chang-Hwan Park, Byung-Wook Kim, Chang Kyun Lee, Hong Jun Park, Byung Ik Jang, Dong Uk Kim, Jin Myung Park, Jae Min Lee, Young Sin Cho, Hyung Ku Chon, Seung Young Seo, Woo Hyun Paik
Gut and Liver.2022; 16(6): 899. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef
Risk Factors for Prolonged Hospital Stay after Endoscopy
Toshihiro Nishizawa, Shuntaro Yoshida, Osamu Toyoshima, Tatsuya Matsuno, Masataka Irokawa, Toru Arano, Hirotoshi Ebinuma, Hidekazu Suzuki, Takanori Kanai, Kazuhiko Koike
Clinical Endoscopy.2021; 54(6): 851. CrossRef

8,217 View
138 Download
6 Web of Science
6 Crossref

Efficacy and Safety of Etomidate in Comparison with Propofol or Midazolam as Sedative for Upper Gastrointestinal Endoscopy: Jae Hyun Kim, Sanghwan Byun, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Moo In Park, Won Moon, Seun Ja Park; Clin Endosc 2020;53(5):555-561. Published online March 31, 2020; DOI: https://doi.org/10.5946/ce.2019.210

Abstract PDF PubReader ePub

Background
/Aims: In this study, we compared the efficacy and safety of etomidate with those of propofol or midazolam for the maintenance of sedation during endoscopy.
Methods
The study enrolled patients who underwent sedative endoscopy in our hospital and divided them into three groups. Patients in each group were administered midazolam as induction therapy and were subsequently administered either midazolam (M + M group), propofol (M + P group), or etomidate (M + E group) as maintenance medication. The primary outcome was overall cardiovascular and respiratory adverse events.
Results
In total, 105 patients who underwent sedative endoscopic examination were enrolled. The outcomes related to the procedure and sedation were not significantly different among the groups. Overall cardiovascular and respiratory adverse events were observed in 9 patients (25.7%) in the M + M group, 8 patients (23.5%) in the M + P group, and 10 patients (27.8%) in the M + E group. The logistic regression analysis revealed that etomidate use was not an independent risk factor for overall cardiovascular and respiratory adverse events.
Conclusions
The outcomes following the use of etomidate for maintenance after induction with midazolam for sedation in upper gastrointestinal endoscopy were not inferior to those following midazolam or propofol use from the perspectives of safety and efficacy.

Citations

Citations to this article as recorded by

Comparison of ciprofol–alfentanil and propofol–alfentanil sedation during bidirectional endoscopy: A prospective, double-blind, randomised, controlled trial
Jiqiang Zhang, Ruijuan Liu, Ruirui Bi, Xia Li, Mengjun Xu, Lijuan Li, Yuxi su, Wenjun Yan
Digestive and Liver Disease.2024; 56(4): 663. CrossRef
Effects of Earmuffs and Eye Masks on Propofol Sedation during Spinal Anesthesia for Orthopedic Surgery: A Randomized Controlled Trial
Jin-Woo Park, Sung Il Bae, Jungyul Ryu, Seung Hyun Chung, Sang-Hwan Do
Journal of Clinical Medicine.2023; 12(3): 899. CrossRef
Effect of intravenous anesthesia by etomidate in combination with propofol on gastrointestinal endoscopy
Bo CHEN, Ke ZHANG, Mingshuai YU
Minerva Surgery.2023;[Epub] CrossRef
New sedatives and analgesic drugs for gastrointestinal endoscopic procedures
Jae Min Lee, Yehyun Park, Jin Myung Park, Hong Jun Park, Jun Yong Bae, Seung Young Seo, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Jun Kyu Lee, Byung-Wook Kim
Clinical Endoscopy.2022; 55(5): 581. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef
Comparative Safety Profiles of Sedatives Commonly Used in Clinical Practice: A 10-Year Nationwide Pharmacovigilance Study in Korea
Yeo-Jin Choi, Seung-Won Yang, Won-Gun Kwack, Jun-Kyu Lee, Tae-Hee Lee, Jae-Yong Jang, Eun-Kyoung Chung
Pharmaceuticals.2021; 14(8): 783. CrossRef
Physical and Chemical Compatibility of Etomidate and Propofol Injectable Emulsions
Chunling Wang, Shengnan Wang, Cuishuan Wu, Li Lei, Dong-Xin Wang, Qiang Zhang
Pharmacology.2021; 106(11-12): 644. CrossRef

5,327 View
213 Download
10 Web of Science
7 Crossref

A Case of Midazolam Anaphylaxis: Jae Gyu Shin, Jong Ho Hwang, Ban Seok Lee, Hye Jung Park, Sang Ho Lee, Jae Nam Lee, Dong Hoon Han, Ji Ha Kim; Clin Endosc 2014;47(3):262-265. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.262

Abstract PDF PubReader ePub

Midazolam is a type of anesthetic agent frequently used for conscious sedation during a variety of medical procedures. Anaphylactic reactions to midazolam are rarely reported. However, we observed a case of midazolam hypersensitivity in which emergency measures were required to ensure patient recovery after administration of midazolam as a sedative. The occurrence of the anaphylactic reaction to midazolam was confirmed by elevated serum tryptase levels. The current case report presents a discussion of our findings.

Citations

Citations to this article as recorded by

Anaphylaxis to Benzodiazepines: A Rare Phenomenon and Review of Literature
Prateek S. Harne, Maneesh Bisen, Parth Sampat, Sahir Quraeshi, Samiran Mukherjee, Zachary Shepherd
American Journal of Therapeutics.2023; 30(2): 155. CrossRef
Allergic and other adverse reactions to drugs used in anesthesia and surgery
Brian A. Baldo
Anesthesiology and Perioperative Science.2023;[Epub] CrossRef
Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations
Andrew Winegarner, Mark C. Kendall, Mekhala Stephen, Afreen Siddiqui, Anjan Trikha
Case Reports in Anesthesiology.2023; 2023: 1. CrossRef
An Unusual Case of Delayed Midazolam Anaphylaxis and a Review of the Current Literature
Nicholas C. Cochran-Caggiano, Deborah Mann, Peter J. Aiello
The Journal of Pediatric Pharmacology and Therapeutics.2023; 28(7): 658. CrossRef
Serious bronchospasm induced by cisatracurium besylate
Ning Wang, Yaozhong Zhang, Yu Hu, Qiyao Yang, Zhenbo Su
Medicine.2021; 100(15): e25516. CrossRef
A Suspected Anaphylactoid Reaction to Propofol in a Dog
Tommaso Del Prete, Stefania Scarabelli
Topics in Companion Animal Medicine.2021; 44: 100536. CrossRef
Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
Guglielmo Capponi, Mattia Giovannini, Ioanna Koniari, Francesca Mori, Chiara Rubino, Gaia Spaziani, Giovanni Battista Calabri, Silvia Favilli, Elio Novembre, Giuseppe Indolfi, Luciano De Simone, Sandra Trapani
Frontiers in Cardiovascular Medicine.2021;[Epub] CrossRef
Out-of-Hospital Emergencies in Children Under Palliative Home Care
Holger Hauch, Naual El Mohaui, Johannes E. A. Wolff, Vera Vaillant, Sabine Brill, Emmanuel Schneck, Natascha Ströter, Ulf Sibelius, Peter Kriwy, Daniel Berthold
Frontiers in Pediatrics.2021;[Epub] CrossRef
Intérêt d’une consultation d’allergologie au décours d’une réaction d’hypersensibilité immédiate aux anesthésiques généraux
N. Bahloul, L. Ben Mahmoud, H. Ghozzi, F. Derbel, G. Rahma, A. Hakim, Z. Sahnoun, S. Kammoun, K. Zeghal
Revue Française d'Allergologie.2020; 60(1): 15. CrossRef
Recognition and management of dermatologic complications from interventional radiology procedures
M. Ramirez, S. Ravichandran, L. Ronald, W.M. Pabon-Ramos, T.P. Smith, C.Y. Kim, J. Ronald
Diagnostic and Interventional Imaging.2019; 100(11): 659. CrossRef
Benzodiazepine Allergy With Anesthesia Administration: A Review of Current Literature
Elliot Haybarger, Andrew S. Young, Joseph A. Giovannitti
Anesthesia Progress.2016; 63(3): 160. CrossRef
Anaphylactic shock caused by intramuscular injection of midazolam during the perioperative period: a case report
Kyu Nam Kim, Dong Won Kim, Yeong Hun Sin, Soo Kyung Lee
Korean Journal of Anesthesiology.2016; 69(5): 510. CrossRef

6,762 View
78 Download
12 Web of Science
12 Crossref

Comparison between Midazolam Used Alone and in Combination with Propofol for Sedation during Endoscopic Retrograde Cholangiopancreatography: Yu Seok Kim, Myung-Hwan Kim, Seung Uk Jeong, Byung Uk Lee, Sang Soo Lee, Do Hyun Park, Dong-Wan Seo, Sung Koo Lee; Clin Endosc 2014;47(1):94-100. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.94

Abstract PDF PubReader ePub

Background/Aims

Endoscopic retrograde cholangiopancreatography (ERCP) is an uncomfortable procedure that requires adequate sedation for its successful conduction. We investigated the efficacy and safety of the combined use of intravenous midazolam and propofol for sedation during ERCP.

Methods

A retrospective review of patient records from a single tertiary care hospital was performed. Ninety-four patients undergoing ERCP received one of the two medication regimens, which was administered by a nurse under the supervision of a gastroenterologist. Patients in the midazolam (M) group (n=44) received only intravenous midazolam, which was titrated to achieve deep sedation. Patients in the midazolam pulse propofol (MP) group (n=50) initially received an intravenous combination of midazolam and propofol, and then propofol was titrated to achieve deep sedation.

Results

The time to the initial sedation was shorter in the MP group than in the M group (1.13 minutes vs. 1.84 minutes, respectively; p<0.001). The recovery time was faster in the MP group than in the M group (p=0.031). There were no significant differences between the two groups with respect to frequency of adverse events, pain experienced by the patient, patient discomfort, degree of amnesia, and gag reflex. Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046).

Conclusions

The combined use of intravenous midazolam and propofol for sedation during ERCP is more effective than midazolam alone. There is no difference in the safety of the procedure.

Citations

Citations to this article as recorded by

Sedation in the Endoscopy Suite
Katherine B. Hagan, Selvi Thirumurthi, Raju Gottumukkala, John Vargo
Current Treatment Options in Gastroenterology.2016; 14(2): 194. CrossRef
Sedation during endoscopic retrograde cholangiopancreatography: a randomized controlled study of patient-controlled propofol sedation and that given by a nurse anesthetist
Andreas Nilsson, Benjamin Grossmann, Eric Kullman, Eva Uustal, Folke Sjöberg, Lena Nilsson
Scandinavian Journal of Gastroenterology.2015; 50(10): 1285. CrossRef
Non‐radiation endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis during pregnancy
Wenming Wu, Douglas O. Faigel, Gang Sun, Yunsheng Yang
Digestive Endoscopy.2014; 26(6): 691. CrossRef
Monitored Anesthesia Care for Sedation during Endoscopic Retrograde Cholangiopancreatography
Young Duck Shin
Korean Journal of Pancreas and Biliary Tract.2014; 19(2): 59. CrossRef
Prerequisites of Colonoscopy
Kyong Hee Hong, Yun Jeong Lim
Clinical Endoscopy.2014; 47(4): 324. CrossRef

7,661 View
92 Download
5 Web of Science
5 Crossref

Propofol versus Midazolam for Sedation during Esophagogastroduodenoscopy in Children: Ji Eun Oh, Hae Jeong Lee, Young Hwan Lee; Clin Endosc 2013;46(4):368-372. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.368

Abstract PDF PubReader ePub

Background/Aims

To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children.

Methods

We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from 34 consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures.

Results

There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30±16.41 minutes) compared with midazolam group (58.89±17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04±19.92 and 97.82±16.7) compared with propofol group (110.26±20.14 and 83.26±12.33; p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures.

Conclusions

Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.

Citations

Citations to this article as recorded by

Procedural Sedation for Pediatric Upper Gastrointestinal Endoscopy in Korea
Yoo Min Lee, Ben Kang, Yu Bin Kim, Hyun Jin Kim, Kyung Jae Lee, Yoon Lee, So Yoon Choi, Eun Hye Lee, Dae Yong Yi, Hyo-Jeong Jang, You Jin Choi, Suk Jin Hong, Ju Young Kim, Yunkoo Kang, Soon Chul Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey
Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki
Clinical Endoscopy.2021; 54(3): 340. CrossRef
Safety of Non-anesthesiologist Administration of Propofol for Gastrointestinal Endoscopy
Jun Kyu Lee, Dong Kee Jang, Won Hee Kim, Jung-Wook Kim, Byung Ik Jang
The Korean Journal of Gastroenterology.2017; 69(1): 55. CrossRef
Analysis of Adverse Events Associated With Adult Moderate Procedural Sedation Outside the Operating Room
Sergey Karamnov, Natalia Sarkisian, Rebecca Grammer, Wendy L. Gross, Richard D. Urman
Journal of Patient Safety.2017; 13(3): 111. CrossRef
Methods for prevention of complications during eyelid and peri-orbital surgery
P. Tan, W.F. Siah, R. Malhotra
Expert Review of Ophthalmology.2016; 11(4): 311. CrossRef
Complications in pediatric endoscopy
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
Best Practice & Research Clinical Gastroenterology.2016; 30(5): 825. CrossRef
Propofol-alfentanyl versus midazolam-alfentanyl in inducing procedural amnesia of upper gastrointestinal endoscopy in children—blind randomised trial
Edyta Sienkiewicz, Piotr Albrecht, Janusz Ziółkowski, Piotr Dziechciarz
European Journal of Pediatrics.2015; 174(11): 1475. CrossRef
Prevalence of Chronic Gastritis orHelicobacter pyloriInfection in Adolescent Sleeve Gastrectomy Patients Does Not Correlate with Symptoms or Surgical Outcomes
Ashanti L. Franklin, Emily S. Koeck, Miller C. Hamrick, Faisal G. Qureshi, Evan P. Nadler
Surgical Infections.2015; 16(4): 401. CrossRef
Barbiturate Induction for the Prevention of Emergence Agitation after Pediatric Sevoflurane Anesthesia
Tadasuke Use, Haruna Nakahara, Ayako Kimoto, Yuki Beppu, Maki Yoshimura, Toshiyuki Kojima, Taku Fukano
The Journal of Pediatric Pharmacology and Therapeutics.2015; 20(5): 385. CrossRef
Same-day bidirectional endoscopy with nonanesthesiologist administration of propofol
Alfredo J. Lucendo, Ángel Arias, Sonia González-Castillo, Teresa Angueira, Danila Guagnozzi, Mariluz Fernández-Fuente, Mercedes Serrano-Valverde, Marta Sánchez-Cazalilla, Oliver Chumillas, Maruja Fernández-Ordóñez, José M. Tenías
European Journal of Gastroenterology & Hepatology.2014; 26(3): 301. CrossRef
Endoscopist-Directed Propofol: Pros and Cons
Eun Hye Kim, Sang Kil Lee
Clinical Endoscopy.2014; 47(2): 129. CrossRef
Comparison of Midazolam and Propofol for Sedation in Pediatric Diagnostic Imaging Studies
Ahmet Sebe, Hayri Levent Yilmaz, Zikret Koseoglu, Mehmet Oguzhan Ay, Muge Gulen
Postgraduate Medicine.2014; 126(3): 225. CrossRef
Endoscopic Sedation: From Training to Performance
Tae Hoon Lee, Chang Kyun Lee
Clinical Endoscopy.2014; 47(2): 141. CrossRef
Harmony of Duet over Solo: Use of Midazolam or Propofol for Sedative Endoscopy in Pediatric Patients
Kwang Hyun Ko, Ki Baik Hahm
Clinical Endoscopy.2013; 46(4): 311. CrossRef

7,998 View
65 Download
14 Crossref

Comparison of Midazolam Alone versus Midazolam Plus Propofol during Endoscopic Submucosal Dissection: Young Shim Cho, Euikeun Seo, Jung-Ho Han, Soon Man Yoon, Hee Bok Chae, Seon Mee Park, Sei Jin Youn; Clin Endosc 2011;44(1):22-26. Published online September 30, 2011; DOI: https://doi.org/10.5946/ce.2011.44.1.22; Retraction in: Clin Endosc 2012;45(1):108

5,375 View
38 Download
3 Crossref

Conscious Sedation During Gastrointestinal Endoscopy: Midazolam vs Propofol: Ja Seol Koo, M.D. and Jai Hyun Choi, M.D.; Korean J Gastrointest Endosc 2011;42(2):67-73. Published online February 28, 2011

Abstract PDF: Endoscopy is increasingly performed with the patient under conscious sedation in many countries. The majority of patients can be adequately and safely sedated during routine upper endoscopy and colonoscopy with a combination of a benzodiazepine and opioid. Midazolam is a water-soluble benzodiazepine that is characterized by a rapid onset of action and a shorter duration compared with that of the other drugs of the same class. The major side effect of midazolam is respiratory depression, which can be reversed by flumazenil, a benzodiazepine-specific antagonist. Propofol is a lipid-soluble agent that has the advantages of a more rapid onset of action and a shorter recovery time compared to that of midazolam. However, it should be used with caution since it can lead to hypotension and respiratory depression. Propofol can be safely and effectively administered by nonanesthesiology physicians and nurses provided that they have received adequate training. Two models have been proposed for the administration of propofol by endoscopists: nurse-administered propofol sedation (NAPS) and combination propofol (propofol plus other agents) sedation. In order to modify the pharmacological disadvantages of propofol, fospropofol sodium, a water-soluble prodrug of propofol, has recently been developed. In addition, new delivery systems have been devised: patient-controlled sedation and computer-assisted personalized sedation, in which the computer continuously monitors the patient's condition and adjusts the dose of propofol accordingly. Endoscopists must have a thorough understanding of the medications used for endoscopic sedation and they must acquire the skills necessary for the treatment of cardiopulmonary complications. Therefore, it is necessary to develop a practice guideline pertaining to endoscopic sedation and also training programs for physicians and nurses in Korea. (Korean J Gastrointest Endosc 2011;42:67-73)

2,770 View
75 Download

The Effects of Flumazenil on the Recovery Time and Satisfaction of the Use of Sedative Endoscopy with Midazolam: Dae-Kyoum Kim, M.D., Hwoon-Yong Jung, M.D.*, Hyo Mi Ko, R.N., Ji Yun Jo, M.D., Seog Gyun Kim, M.D., Don Lee, M.D., Hye-Sook Chang, M.D., Hye-Kyung Song, M.D., Hyun Ju Lee, M.D., Eun Ju Chung, M.D., Hye Won Park, M.D. and Jin Ho Kim, M.D.*; Korean J Gastrointest Endosc 2008;36(4):206-212. Published online April 30, 2008

Abstract PDF: Background
/Aims: Treatment with flumazenil results in rapid reversal from sedation. In addition, the use of flumazenil can prevent accidents or memory loss after endoscopy. This study was conducted to evaluate the role of flumazenil according to dose. Methods: A total of 150 consecutive outpatients were randomly allocated into three groups: patients given normal saline (control group), patients given 0.25 mg flumazenil (0.25 mg flumazenil group) and patients given 0.5 mg flumazenil (0.5 mg flumazenil group). Flumazenil or normal saline was injected 10 minutes after the completion of endoscopy. We evaluated the recovery time, time to discharge, patient satisfaction, and memory loss after discharge. Results: The control group consisted of 44 subjects, the 0.25 mg flumazenil group consisted of 46 subjects and the 0.5 mg flumazenil group consisted of 45 subjects. The recovery time was significantly shorter in the two flumazenil groups as compared to the control group (28.5±15.0 min, 13.8±3.7 min, 12.4±1.7 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively)(p＜0.001). The time to discharge after an examination was shorter in the flumazenil groups and showed dose-dependency (41.2±20.5 min, 22.1±10.9 min, 16.4±2.2 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively) (p＜0.001). There was no significant difference in patient satisfaction among the three groups. The degree of memory recall was better in the 0.5 mg flumazenil group than in the other two groups (p＜0.001). Conclusions: Flumazenil reversal of midazolam sedative endoscopy results in fast recovery and is helpful to minimize memory loss after an examination without interference of satisfaction. (Korean J Gastrointest Endosc 2008;36:206-212)

1,969 View
20 Download

Conscious Sedation with Midazolam Combined with Propofol for Colonoscopy: Ja Seol Koo, M.D., Jai Hyun Choi, M.D., Sung Woo Jung, M.D., Woo Sik Han, M.D., Jong Sup Lee, M.D., Hyung Joon Yim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Sang Woo Lee, M.D., Chang Duck Kim, M.D. and Ho Sang Ryu, M.D.; Korean J Gastrointest Endosc 2007;34(6):298-303. Published online June 30, 2007

Abstract PDF: Background/Aims: There is increasing interest in the use of propofol as a sedative agent for colonoscopy. We evaluated the safety and efficacy of the synergistic sedation with midazolam combined with low-dose propofol versus that of midazolam alone. Methods: A total of 56 patients from among those who underwent total colonoscopy between August 2004 and October 2004 were randomly assigned to one of three medication treatment groups. Group A (n=18) received low-dose midazolam (0.03 mg/kg IV) plus propofol, group B (n=19) received high-dose midazolam (0.07 mg/kg IV) plus propofol, and group C (n=19) received high-dose midazolam alone. The patients' vital signs were monitored throughout the course of the study. The recovery time and quality as well as the patients' comfort level were also assessed. Results: There were no significant differences in baseline characteristics among the treatment groups. There were also no differences in the duration and insertion time of the colonoscopy among the three groups. The patients' comfort level and cardiorespiratory parameters during colonoscopy were similar among the three groups. The sedation efficacy and recovery times were also similar among the three groups. Conclusions: Midazolam combined with low-dose propofol as a sedative for colonoscopy exhibits similar effects on safety, patient' comfort level and recovery time to those of midazolam alone.

2,283 View
33 Download

The Effect of Fixed Dose of Flumazenil on Recovery after Sedative Endoscopy by Midazolam: Kye Hyoung Kwon, M.D., Young Sook Park, M.D., Tae Hun Kim, M.D., Yun Ju Jo, M.D., Moon Hee Song, M.D., Chung Hyeon Kim, M.D. and Seong Hwan Kim, M.D.; Korean J Gastrointest Endosc 2006;32(6):361-367. Published online June 30, 2006

Abstract PDF: Background
/Aims: Midazolam is widely used as a form of conscious sedation during endoscopy because of its rapid onset and safety. However, its relatively long half-life and paradoxical reactions are still a concern for doctors and patients. Flumazenil is a competitive benzodiazepine antagonist that acts to reverse the sedative and hypnotic effects of midazolam but its role and adequate dose have not been fully documented. This study evaluated the effect of a fixed dose of flumazenil on the recovery from sedative endoscopy by midazolam. Methods: First study: 100 patients who received 0.05 mg/kg midazolam for conscious sedation were randomized into two groups: intravenous 0.25 mg flumazenil and a placebo. All patients were assessed using OAA/S (Observers Assessment of Alertness/Sedation Scale) scale (responsiveness, speech, facial expression and ptosis of eyelid) before the endoscopy, immediately after the procedure and every 5 minutes thereafter. The recovery time was defined as the time at which the OAA/S scale reached the pre-endoscopy level. Second study: In 40 patients, the OAA/S scale was assessed only after full recovery without any exogenous stimuli. The total dose of midazolam and the procedure time were assessed. Results: The flumazenil group demonstrated a significantly shorter recovery time than the placebo group (p＜0.0001). These results were not affected by age, gender, total midazolam dose and procedure time. There was a larger difference in the recovery time between the two groups in the second study than in the first. Conclusions: A fixed low dose flumazenil significantly reduced the recovery time after sedative endoscopy by midazolam. Flumazenil will be helpful for the early return to daily activities and for preventing post sedative complication. (Korean J Gastrointest Endosc 2006;32:361⁣367)

1,768 View
24 Download

Effects of Chronic Alcohol Consumption on Midazolam Induced Sedation during Colonoscopy: Young Sook Park, M.D., Jong Yong Lee, M.D., Yu Seoung Seo, M.D., Chung Hyeon Kim, M.D., Jung Don Lee, M.D., Hyun Suk Lee, M.D., Kye Hyung Kwon, M.D.,Tae Hun Kim, M.D. and Yun Ju Jo, M.D.; Korean J Gastrointest Endosc 2004;29(6):495-499. Published online December 30, 2004

Abstract PDF: Background
/Aims: It is suggested that patients consuming large amounts of alcohol are difficult to be sedated by midazolam probably due to cross tolerance. We studied to know the adequate administration doses of midazolam in patients with chronic alcohol consumption. Methods: Study I; We prospectively studied 117 outpatients presenting for colonoscopy. According to alcohol consumption we divided four groups such as group I: 0 g/day, group II: ＜10 g/day, group III: 10∼40 g/day, group IV: ＞40 g/day. We initially administered 0.06 mg/kg midazolam and add up to spontaneous eye closure. We measured grade of amnesia, level of consciousness, endoscopist's assessment and VAS scale for pain after recovery. Study II; We measured induction time after 0.08 mg/kg midazolam in 60 patients who drink alcohol. Results: Additional amount of midazolam was not significantly different between the groups (group I: 0.0145 mg/ kg, group II: 0.0214 mg/kg, group III: 0.0181 mg/kg, group IV: 0.0199 mg/kg). There were no differences of sedation parameters between the groups. However the induction time was prolonged and correlated with alcohol consumption. Conclusions: For adequate sedation in patients with chronic alcohol consumption, longer induction time rather than increasing dosage is required. (Korean J Gastrointest Endosc 2004;29:495⁣499)

2,451 View
33 Download

내시경적 역행성 췌담관조영술에서 Midazolam 에 의한 얕은 진정 후의 역설적 반응에 관한 예측인자 ( Predictable Factors for Paradoxical Reactions in Conscious Sedation with Midazolam During ERCP ): Korean J Gastrointest Endosc 2001;23(6):451-460. Published online November 30, 2000

PDF

2,427 View
18 Download

내시경적역행성췌담관조영술에서 Midazolam 에 의한 얕은 진정 후의 역행성 반응에 관한 예측인자: Korean J Gastrointest Endosc 2001;23(5):319-319. Published online November 30, 2000

PDF

1,249 View
3 Download

알코올의 섭취량이 대장 수면내시경 시 Midazolam 투여량에 미치는 영향: Korean J Gastrointest Endosc 2001;23(5):316-316. Published online November 30, 2000

PDF

1,464 View
2 Download

수면내시경 검사에서 Midazolam 전처치와 Flumazenil 길항작용에 대한 연구 ( Effectiveness of Flumazenil against Midazolam as Premedication for Upper Gastrointestinal Endoscopy ): Korean J Gastrointest Endosc 2000;21(1):518-524. Published online November 30, 1999

Abstract PDF: Background
/Aims : Midazolam is utilized as a premedication for uppoer gastrointestinal endoscopy. Midazolam has a more rapid onset of reaction than that of diazepam and its duration is shorter. But the Consciousness of premedicated patients has not been regained sooner. The Purpose of this study was to examine the effectiveness of flumazenil against midazolam as premedication for upper gastrointesinal endoscopy. Methods : Sixty patients underwent upper gastrointestinal endoscopy. These patients were divided to three groups: Group I included twenty patients without premedication; Group Ⅱ Included twenty patients with premedication of midazolam and then were not given an antisedative agent excluign of normal saline; and Group Ⅲ included the others with midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam injection, compared with presedation value. Modified Steward Coma Scale showed a significant increase after flumazenil injection as an antagonist of midazolam. The assessment of the endoscopist and the comfort of patients were satisfactory. When the 40 patients were asked about their willingness to undergo the same procedure in the future, thirty-four patients responded favorably. Conclusion : Midazolam was safe and effective for sedation for upper gastrointestinal endoscopy. There was rapid regaining of consciousness with flumazenil indection after midazolam, so the use of flumazenil against midazolam injection also appeared to be effective. ( Korean J Gastrointest Endosc 2000;21:518-524)

1,792 View
12 Download

대장 내시경 검사시 전처치제로서 Midazolam 단독 사용에 관한 연구 ( Midazolam as a Premedication for Colonoscopy ): Korean J Gastrointest Endosc 1999;19(1):33-40. Published online November 30, 1998

Abstract PDF: Background
As the frequency of colonoscopic approaches increases, we need a less painful premedication for colonoscopy. We used midazolam as a premedication agent. It has more rapid onset of action than that of diazepam and its duration is shorter. The purpose of this study was to examine the clinical application of midazolam. Methods: Fifty patients underwent colonoscopies. An average dose of midazolam, 0.07 mg/kg, was given to patients intravenously as premedication. We measured systolic and diastolic blood pressures, pulse rates, respiratory rates, and oxygen saturation (SaO2) using pulse oxymetry before and after the injection. A Trieger test was accomplished before and after the procedures. We examined the levels of consciousness with verbal and physical stimulation during the colonoscopy. The examiners noted the degree of amnesia and pain after colono-scopy. We examined the patients' satisfaction and endoscopists' assessments. Results: 1) Systolic, diastolic blood pressures and respiratory rates showed no significant changes. But, pulse rates increased meaningfully at 15 minutes after the injection of midazolam (p ＜0.05). 2) The Trieger test showed meaningfully increased numbers of missed dots after the injection of midazolam. 3) The levels of consciousness during the test showed alertness in 22 patients (44%), drowsy mentality in 22 patients (44%) and stuporous mentality in 6 patient (12%). 4) The degree of amnesia after examination showed recall in 26 patients (52%), partial recall in 10 patients (20%) and total amnesia in 14 patients (28%). 5) Forty-five patients (90%) acknowledged this procedures to be more comfortable than previous procedures. Conclusions: Midazolam stabilized vital signs and oxygen saturation, therefore midazolam can be used safely as premedication for colonoscopy. Thirty-six patients (72%) recalled the procedures totally or partially. But, the relief of pain compared favorably to the degree of amnesia. We concluded that mida-zolam (0.07 mg/kg) was the safe and effective premedication for colonoscopy. (Korean J Gastrointest Endosc 18: 33 ∼40, 1999)

1,522 View
4 Download

원저 : 식도 위장관 ; 대장내시경 전처치로서 저 용량 Midazolam 의 유용성에 관한 연구 ( Original Articles : Esophagus , Stomach & Intestine ; Effect of Low - Dose Midazolam for Colonoscopy ): Korean J Gastrointest Endosc 1998;18(4):499-505. Published online November 30, 1997

Abstract PDF: Background
/Aims: Because colonoscopy is a painful procedure, analgesics and sedatives may be necessary as premedication. Midazolam reacts quicker, has a more excellent amnesic effect and fewer complications compared to diazepam. The effects of midazolam depend on dose, age, and rapidity of injection. According to several studies, side effects of midazolam were more common in high-dose injections (more than 5 mg) compared to low dose injections (0.03-0.05 rng/kg). Moreover, low dose injections were found to be as effective as high dose injections. However, there was no report about the effect and the side effects of midazolam in Korea. Therefore, we performed this study to determine the effect of low dose midazolam as premedication for colonoscopy, Methods: We performed colonoscopy in 99 consecutive patients who were randomly selected (midazolam group: 50, placebo group: 49) prospectively from July 1996 to September 1996. Premedication was administered through intravenous injection of midazolam or saline 0.03 mg/kg, combined with intramuscular injections of meperidine 50 mg, and intravenous injections of Buscopan 20 mg in all patients. Blood pressure, puise rate, and O2 saturation by oxymeter were checked before, during, and 30 minutes after colonoscopy. The degree of amnesia, discomfort, cooperation and acceptance of the re-examination were checked. (Korean J Gastrointest Endosc 18: 499-505, 1998) (continue)

1,476 View
2 Download

원저 : 식도 위장관 ; 상부 위장관 내시경 검사시 전처치로서의 Midazolam 의 효과 ( Original Articles : Esophagus , Stomach & Intestine ; Midazolam as Premedication for Upper Gastrointestinal Endoscopy ): Korean J Gastrointest Endosc 1996;16(2):181-190. Published online November 30, 1995

Abstract PDF: The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p<0.05), and midazolam group would accept the same sedation for repeated endoscopies(p<0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy. (Korean J Gastrointest Endoec 16: 181-190, 1996)

1,545 View
7 Download

Search