Gastrointestinal endoscopy
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Gastrointest. Endosc. · May 2018
Randomized Controlled Trial Comparative StudyContinued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.
Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients. ⋯ Endoscopists performing moderate sedation should continue midazolam rather than switching to diphenhydramine in patients who do not achieve adequate sedation with usual doses of midazolam and an opioid. (Clinical trial registration number: NCT01769586.).