Effect of midazolam on memory during fiberoptic gastroscopy under conscious sedation
Yun Jeong Hong1, Eun Hye Jang, Jihye Hwang
1*Department of Neurology, and †Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Objective:
As the fiberoptic gastroscopy using midazolam is being in widespread use, the exact nature of midazolam on memory should be clarified. We intended to examine whether midazolam causes selective anterograde amnesia and what impact it has on other aspects of memory and general cognitive function.
Methods:
We recruited healthy subjects undergoing fiberoptic gastroscopy under conscious sedation. At baseline, history taking for retrograde amnesia and the Korean version of the Montreal Cognitive Assessment were performed. A man's name and address were given immediately after intravenous midazolam administration. After gastroscopy, the subjects were asked to recall those items. By the time they had fully recovered consciousness, the same test was repeated along with the Korean version of the Montreal Cognitive Assessment and a test for retrograde amnesia.
Results:
A total of 30 subjects were enrolled in this study. Subjects with high-dose midazolam showed lower scores in the immediate and delayed recall of "a man's name and address" compared with those with low-dose midazolam. The midazolam dose was inversely correlated with the delayed recall scores of "a man's name and address." On full recovery of consciousness, the subjects did not exhibit any of anterograde or retrograde amnesia.
Conclusions:
These findings suggest that midazolam causes transient selective anterograde amnesia in a dose-dependent manner.
Insights
Midazolam used during gastroscopy can cause temporary, dose-dependent anterograde amnesia, affecting memory recall. This effect was observed in healthy subjects undergoing the procedure.
Area of Science:
- Anesthesiology
- Neuroscience
- Pharmacology
Background:
- Fiberoptic gastroscopy commonly uses midazolam for conscious sedation.
- The precise impact of midazolam on memory requires clarification.
Purpose of the Study:
- To investigate if midazolam induces selective anterograde amnesia.
- To assess midazolam's effects on other memory aspects and cognitive functions.
Main Methods:
- Healthy subjects undergoing gastroscopy were recruited.
- Memory recall tests (name/address) and cognitive assessments (MoCA) were administered before and after midazolam sedation.
- Retrograde amnesia was also evaluated.
Main Results:
- Higher midazolam doses correlated with lower immediate and delayed recall scores.
- No significant anterograde or retrograde amnesia was observed upon full recovery.
- A dose-dependent inverse relationship was found between midazolam dosage and delayed recall.
Conclusions:
- Midazolam administration during gastroscopy can lead to transient, dose-dependent anterograde amnesia.
- The amnesic effect appears selective and temporary.
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