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[Midazolam and Meperidine for colonoscopy]

W L Peng1, J M Wong, G J Wu

  • 1Department of Anesthesiology Sun-Yat-Sen Cancer Center, Taipei.

Ma Zui Xue Za Zhi = Anaesthesiologica Sinica
|December 1, 1993
PubMed
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Intravenous midazolam and meperidine significantly reduced pain and improved patient satisfaction during colonoscopy compared to intramuscular meperidine. This combination offers better procedural sedation and amnesia for patients undergoing colonoscopy.

Area of Science:

  • Gastroenterology
  • Anesthesiology
  • Pharmacology

Background:

  • Colonoscopy is a common procedure requiring sedation for patient comfort and safety.
  • Traditional intramuscular sedation methods may provide inadequate analgesia and amnesia.
  • Evaluating novel intravenous sedation regimens is crucial for optimizing colonoscopy outcomes.

Purpose of the Study:

  • To compare the sedative, analgesic, and amnesic effects of intravenous midazolam and meperidine versus intramuscular meperidine for colonoscopy.
  • To assess patient satisfaction, vital sign changes, safety, and complications associated with each sedation method.

Main Methods:

  • A randomized study of 299 patients undergoing colonoscopy.
  • Group IM-MB received intramuscular meperidine (50 mg) and Hyoscine-N-Butylbromide (20 mg).

Related Experiment Videos

  • Group IV-MMB received intravenous midazolam (0.05 mg/kg), meperidine (1 mg/kg), and Hyoscine-N-Butylbromide (20 mg), with SaO2 monitoring.

    • Main Results:

    • Significantly lower severe pain responses in Group IV-MMB (13%) vs. Group IM-MB (51%).
    • Higher immediate procedure recall of severe pain in Group IM-MB (39%) vs. Group IV-MMB (3%).
    • Greater patient satisfaction in Group IV-MMB (92%) vs. Group IM-MB (21%).
    • Both groups showed increased heart rate; Group IV-MMB had significant SaO2 decrease (4.5%).

    Conclusions:

    • Intravenous midazolam and meperidine provide superior analgesia, amnesia, and patient satisfaction for colonoscopy compared to intramuscular meperidine.
    • The intravenous combination is effective but requires careful monitoring of oxygen saturation due to potential decreases.
    • This regimen represents an improved option for procedural sedation in colonoscopy.