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Sedation for endoscopy: midazolam or diazepam and pethidine?
D A Boldy1, L R Lever, P R Unwin
1Department of Medicine, Wycombe General Hospital, High Wycombe, Bucks.
British Journal of Anaesthesia
|December 1, 1988
Summary
Midazolam provided superior amnesia during upper gastrointestinal endoscopy. However, diazepam with pethidine offered reduced retching and less post-procedure sedation, improving patient performance and recall.
Area of Science:
- Gastroenterology
- Pharmacology
- Anesthesiology
Background:
- Sedation is crucial for patient comfort during upper gastrointestinal endoscopy.
- Assessing the optimal sedative agent balances procedural efficacy with patient experience.
Purpose of the Study:
- To compare the efficacy and patient-reported outcomes of midazolam versus diazepam/pethidine for upper gastrointestinal endoscopy sedation.
Main Methods:
- A double-blind, randomized study involving 100 patients undergoing upper gastrointestinal endoscopy.
- Patients received either midazolam alone or diazepam with pethidine, antagonized with naloxone.
Main Results:
- Midazolam significantly improved amnesia for the procedure (P < 0.0001).
- Diazepam/pethidine combination led to less retching (P < 0.01) and reduced post-procedure sedation, evidenced by performance tests and patient recall (P < 0.02).
Conclusions:
- Midazolam offers superior amnesia, while diazepam/pethidine provides better control over procedural discomfort and post-sedation effects.
- The choice of sedative agent should consider the trade-off between amnesia and procedural tolerance.