Patient satisfaction after endoscopic submucosal dissection under propofol-based sedation: a small premedication...

Area of Science:

• Gastroenterology
• Anesthesiology
• Clinical Pharmacology

Background:

• Patient satisfaction during endoscopic submucosal dissection (ESD) is crucial but often not aligned with endoscopist satisfaction.
• Propofol-based sedation is common for ESD, but optimizing patient experience remains a challenge.
• Investigating novel premedication strategies can enhance patient comfort and acceptance of ESD procedures.

Purpose of the Study:

• To evaluate the efficacy of low-dose midazolam as premedication to improve patient satisfaction during propofol-based sedation for ESD.
• To determine if midazolam premedication influences patient willingness to undergo similar procedures in the future.
• To assess the impact of midazolam on procedural outcomes and endoscopist satisfaction.

Main Methods:

• A randomized controlled trial involving 72 adult patients undergoing ESD.
• Patients received either midazolam (0.02 mg/kg) or placebo as premedication before propofol and fentanyl sedation.
• Patient and endoscopist satisfaction, procedural data, and future willingness were assessed.

Main Results:

• The study was terminated early due to significantly higher patient willingness for future procedures in the midazolam group (P=0.001).
• No significant differences were observed in sedation/procedure/recovery times, drug requirements, or adverse events between groups.
• Patient and endoscopist satisfaction scores, pain, and recall were comparable across both groups.

Conclusions:

• Low-dose midazolam premedication effectively reduces patient reluctance for repeat ESD procedures.
• This strategy enhances patient acceptance without compromising procedural efficiency or endoscopist satisfaction.
• Midazolam offers a valuable adjunct for optimizing patient-centered care in ESD sedation.