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Conscious sedation and cardiorespiratory safety during colonoscopy
M Ristikankare1, R Julkunen, M Mattila
1Departments of Medicine, Research, and Clinical Physiology, Kuopio University Hospital, Finland.
Gastrointestinal Endoscopy
|July 7, 2000
Summary
Midazolam sedation during colonoscopy significantly lowers oxygen saturation and increases hypotension risk. However, the colonoscopy procedure remains safe, with or without sedation.
Area of Science:
- Gastroenterology
- Anesthesiology
- Cardiology
Background:
- Cardiorespiratory events are common during colonoscopy.
- The impact of sedative premedication on these events lacks controlled trial data.
Purpose of the Study:
- To prospectively evaluate the effect of midazolam premedication on cardiorespiratory parameters during colonoscopy.
- To compare midazolam sedation with placebo and no sedation.
Main Methods:
- 180 patients undergoing colonoscopy were randomized into three groups: midazolam sedation, saline placebo, or no intravenous cannula.
- Arterial oxygen saturation (SaO(2)), blood pressure, and ECG were monitored throughout the procedure.
Main Results:
- Midazolam significantly reduced SaO(2) compared to placebo and control groups.
- Hypotension occurred more frequently in the midazolam group (19%) versus placebo (3%) and control (7%).
- ST-segment depression was observed but did not differ significantly between groups, often appearing before the procedure.
Conclusions:
- Midazolam premedication decreases arterial oxygen saturation and elevates hypotension risk during colonoscopy.
- Despite these effects, colonoscopy is a safe procedure, whether performed with or without sedation.