• Turk J Gastroenterol · Mar 2008

    Randomized Controlled Trial Comparative Study

    Comparison of the effects of intravenous midazolam alone and in combination with meperidine on hemodynamic and respiratory responses and on patient compliance during upper gastrointestinal endoscopy: a randomized, double-blind trial.

    • A Melih Ozel, Kemal Oncü, Yusuf Yazgan, Ahmet Kemal Gürbüz, and Levent Demirtürk.
    • Department of Gastroentorology, Gülhane Military Medical Academy, Haydarpafla Training Hospital, Istanbul, Turkey. melihozel@superonline.com
    • Turk J Gastroenterol. 2008 Mar 1;19(1):8-13.

    Background/AimsWe examined hemodynamic responses during gastroscopy in healthy subjects and compared the changes with midazolam alone versus in combination with meperidine. The aim of this study was to evaluate if either method had any advantages or disadvantages with respect to patient compliance and the commonly seen side effects.MethodsThirty patients who were otherwise healthy were included in each group. Either midazolam 0.05 mg/kg IV (Group I) or meperidine 0.3 mg/kg IV followed by midazolam 0.05 mg/kg (Group II) IV were used for sedation. Data of noninvasive hemodynamic and cardiac parameters were recorded before and at the 1st minute after medication, and at the 1st minute and 2-min intervals during the procedure. Endoscopists assessed the comfort of patients according to pre-determined criteria. Statistical analysis was performed for both inter-group and in-group comparisons of parameters.ResultsHeart rate increased significantly in Group I (p<0.05). Blood pressures and oxygen saturation decreased significantly with sedation in both groups during endoscopy (p<0.05), without significant difference between the groups for the changes in these parameters (p>0.05). Patient compliance was significantly better in Group II than in Group I, for all measured criteria.ConclusionsWe observed that heart rate increases significantly whereas SAP, DAP and SpO2 decrease significantly with both sedation methods. Groups did not differ except for the significantly higher increase in heart rate in Group I. Patient compliance was significantly better with combined sedation. We believe that combined sedation in selected patients provides a safe sedation with a mild to moderate increase in heart rate and a better patient compliance during gastroscopy.

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