The effect of sedation during upper gastrointestinal endoscopy

Area of Science:

• Gastroenterology
• Anesthesiology
• Clinical Pharmacology

Background:

• Sedation is often used to reduce patient discomfort during endoscopic procedures.
• Diazepam and midazolam are commonly used sedatives with different pharmacokinetic profiles.

Purpose of the Study:

• To evaluate the efficacy of sedation in reducing patient discomfort during upper gastrointestinal endoscopy.
• To compare the effectiveness of longer-acting diazepam versus shorter-acting midazolam for sedation.

Main Methods:

• A prospective, randomized, single-blinded study involving 252 patients undergoing endoscopy.
• Patients were randomized to receive placebo, diazepam, or midazolam before the procedure.
• Patient discomfort and physician comfort were assessed using a visual analogue scale.

Main Results:

• No statistically significant difference in patient discomfort was observed between sedated and unsedated groups (P=0.0754).
• Physician comfort during endoscopy was significantly higher in sedated patients compared to unsedated patients (P=0.0461).
• Both diazepam and midazolam were equally effective in improving physician comfort (P=0.617).

Conclusions:

• Sedation with midazolam or diazepam does not significantly reduce patient discomfort during endoscopy.
• Endoscopists experienced greater ease performing procedures on sedated patients.
• There was no significant difference in patient discomfort or physician comfort between diazepam and midazolam.