Gastrointestinal endoscopy
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Gastrointest. Endosc. · Jun 1999
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of midazolam and diazepam for conscious sedation during colonoscopy in a prospective double-blind study.
Midazolam and diazepam are commonly used for conscious sedation, but their comparative respiratory depressive effects have not been accurately studied. We used a novel real-time, on-line, computerized data acquisition system to compare the two agents in a randomized double-blind study. ⋯ Midazolam was 3.4 times more potent than diazepam. The duration of oxygen desaturation emphasizes the importance of monitoring SpO2 until ventilation and oxygenation have recovered. Although the degree of hypoxemia was comparable, midazolam led to higher end-tidal carbon dioxide tensions.
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Gastrointest. Endosc. · Jun 1999
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study.
Adequate patient sedation is mandatory for diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The short-acting anesthetic propofol offers certain potential advantages for endoscopic procedures, but controlled studies proving its superiority over benzodiazepines for ERCP are lacking. ⋯ Intravenous sedation with propofol for ERCP is (1) more effective than sedation with midazolam, (2) safe under adequate patient monitoring, and (3) associated with a faster postprocedure recovery.
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Gastrointest. Endosc. · May 1999
Randomized Controlled Trial Clinical TrialImpact of flumazenil on recovery after outpatient endoscopy: a placebo-controlled trial.
Flumazenil is an imidazobenzodiazepine that blocks the central effects of benzodiazepines by competitive interaction at the receptor level. In this study we assessed the impact of flumazenil use on postsedation observation time in outpatients undergoing endoscopy. ⋯ Flumazenil significantly reduces postsedation observation time. Actual cost savings will vary depending on staff and facility capacity, patient volume, flumazenil cost, and unit cost of observation time.
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Gastrointest. Endosc. · Jun 1998
Randomized Controlled Trial Clinical TrialPlacebo-controlled trial assessing the use of oral midazolam as a premedication to conscious sedation for pediatric endoscopy.
This study was performed to evaluate the effect of midazolam, as premedication before intravenous conscious sedation, on preprocedural, procedural, and post-procedural patient comfort and anxiety in children undergoing endoscopy. ⋯ Oral midazolam is an effective and safe premedication for children undergoing upper endoscopy and should be used in all anxious children and in patients previously judged to be difficult to sedate.
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Gastrointest. Endosc. · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialMidazolam versus diazepam in lipid emulsion as conscious sedation for colonoscopy with or without reversal of sedation with flumazenil.
The efficacy and tolerance of midazolam (Dormicum R) versus diazepam in lipid emulsion (Diazemuls R, Dumex) was evaluated in a randomized, controlled, double-blind trial in 200 patients undergoing total colonoscopy. ⋯ We conclude that midazolam can be used safely in relatively fit patients between 17 and 65 years old and that it is the drug of choice if amnesia is desirable. As sole premedication this drug was insufficient in 42% of the patients (pain score was greater than 3), especially in young women.