[Comparative study between midazolam and diazepam in upper gastrointestinal endoscopy premedication].

Area of Science:

• Gastroenterology
• Pharmacology
• Anesthesiology

Background:

• Conscious sedation and anxiolysis are crucial for patient comfort during upper gastrointestinal endoscopy.
• Benzodiazepines are commonly used for sedation, but their comparative efficacy and safety profiles require ongoing evaluation.

Purpose of the Study:

• To prospectively compare the efficacy and safety of midazolam versus diazepam for conscious sedation during upper gastrointestinal endoscopy.
• To assess improvements in patient tolerance, conscious sedation, and anxiolysis.

Main Methods:

• A prospective study involving 71 patients undergoing upper gastrointestinal endoscopy.
• Patients were randomized to receive either intravenous diazepam (0.15 Mg/Kg) or midazolam (0.07 mg/kg).
• Exclusion criteria included benzodiazepine intolerance, pregnancy, substance addiction, and chronic debilitating diseases.

Main Results:

• Midazolam demonstrated a marked improvement in conscious sedation and anxiolysis compared to diazepam (p<0.001).
• Significantly higher rates of amnesia were observed in the midazolam group (total 77.14%, partial 17.14%) versus the diazepam group (total 11.11%, partial 2.77%).
• No clinically adverse cardiopulmonary events occurred in either group, indicating good safety.

Conclusions:

• Midazolam offers superior conscious sedation and anxiolysis for upper gastrointestinal endoscopy compared to diazepam.
• Midazolam significantly enhances patient tolerance to endoscopic procedures.
• Careful patient selection is essential for ensuring safety during sedation.