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THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY

Year 2001, Volume: 14 Issue: 2, 96 - 100, 03.12.2016

Abstract

Objective: The use of sedation in upper gastrointestinal endoscopy is widespread because of better patient tolerance. As this sedation is usually performed by nonanesthesiologists in and outside of hospital settings, possible adverse effects arising during the procedure must be dealt with carefully. In this study, the safety and efficacy of midazolam for conscious sedation in 100 patients undergoing upper gastrointestinal endoscopy were evaluated prospectively.
Patients and Methods: Hundred consecutive patients undergoing upper gastrointestinal endoscopy were sedated with intravenous midazolam. The dose of midazolam was titrated according to the patient’s need and the duration of the procedure. Heart rate and oxygen saturation of all the patients were continuously monitored during the procedure and any complications were recorded. The amnesic effect of midazolam and patient comfort were also evaluated.
Results: During the procedure, absence of oxygen desaturation (Sa02 > 95%) was found in 80%, mild oxygen desaturation (95% > Sa02 > 92%, at least 15 seconds duration) in 16%, and
severe oxygen desaturation (Sa02 < 92%, at least 15 seconds duration) in 4%. Twenty-six patients had tachycardia only during the insertion of the endoscope, 17 patients had it throughout the procedure. Ventricular premature beats were recorded in two patients. Different degrees of amnesia were seen in 60% of the patients and the comfort level was excellent in 41%, good in 43%, and fair in 16%.
Conclusion: Sedation of patients undergoing upper gastrointestinal endoscopy with intravenous midazolam results in better tolerance of the procedure. Routine monitoring must be provided because of the risks of desaturation and arrhythmia.
Key Words: Midazolam, Conscious sedation, Upper gastrointestinal endoscopy.

References

  • Bell GD. Review article: premedication and intravenous sedation for upper gastrointestinal endoscopy. Aliment Pharmacol Ther 1990;4:103-122.
  • Morgan GE, Mikhail MS. Clinical Anesthesiology. Connecticut: Appleton & Lange, 1992:1-12.
  • Whitwam JG. Anxiolysis, sedation and anaesthesia. In: Whitman JG, McCloy RE, eds. Principles and practice of sedation. London: Blackwell Science, 1998:3-7.
  • Practice guidelines for sedation and analgesia by non-anaesthesiologists: A report by the American Society of Anesthesiologists Task Force on Sedation. Anesthesiology 1996;84:459-471.
  • Bell GD, McCloy RF, Charlton JE, et al. Recommendations for standards of sedation and patient monitoring during gastrointestinal endoscopy. Gut 1991 ;32:823-827.
  • Tan CC, Freeman JG. Throat spray for upper gastrointestinal endoscopy is quite acceptable to patients. Endoscopy 1996;28:277-282.
  • Campo R, Brullet E, Montserrat A, et al. Identification of factors that influence tolerance of upper gastrointestinal endoscopy. Eur J Gastroenterol Hepatol 1999; 11:201-204.
  • Wang CY, Ling LC, Cardosa MS, Wong AR, Wong HW. Hypoxia during upper gastrointestinal endoscopy with and without sedation and the effect of pre-oxygenation on oxygen saturation. Anaesthesia 2000,55:654- 658.
  • Iwao T, Toyonaga A, Harada H, et al. Arterial oxygen desaturation during non-sedated diagnostic upper gastrointestinal endoscopy. Gastrointest Endosc 1994;40:277-280.
  • Alcain G, Guillen P, Escolar A, Moreno M, Martin L. Predictive factors of oxygen desaturation during upper gastrointestinal endoscopy in non-sedated patients. Gastrointest Endosc 1998;48:143-147.
  • Yen D, Hu SC, Chen LS, et al. Arterial oxygen desaturation during emergent non-sedated upper gastrointestinal endoscopy in the emergency department. Am J Emerg Med 1997;15:644-647.
  • Tinnesen H, Puggaard L, Braagaard J, Ovesen H, Rasmussen V, Rosenberg J. Stress response to endoscopy. Scand J Gastroenterol 1999;54:629-631.
  • Schenck J, Müller CH, Lubbers H, Mahlke R, Lehnick D, Lankisch PG. Does gastroscopy induce myocardial ischemia in patients with coronary heart disease? Endoscopy 2000;32:373-376.
  • Wilcox CM, Faibicher M, Wenger HR, Shalek RA. Prevalence of silent myocardial ischemia and arrhythmias in patients with coronary heart disease undergoing gastrointestinal tract endoscopic procedures. Arch Intern Med 1993; 153:2325-2330.
  • Oei Lim VL, Ralkman CJ, Bartelsman JF, Res JC, Van Wezel HB. Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol. Eur J Anaesthesiol 1998; 15:535-543.
Year 2001, Volume: 14 Issue: 2, 96 - 100, 03.12.2016

Abstract

References

  • Bell GD. Review article: premedication and intravenous sedation for upper gastrointestinal endoscopy. Aliment Pharmacol Ther 1990;4:103-122.
  • Morgan GE, Mikhail MS. Clinical Anesthesiology. Connecticut: Appleton & Lange, 1992:1-12.
  • Whitwam JG. Anxiolysis, sedation and anaesthesia. In: Whitman JG, McCloy RE, eds. Principles and practice of sedation. London: Blackwell Science, 1998:3-7.
  • Practice guidelines for sedation and analgesia by non-anaesthesiologists: A report by the American Society of Anesthesiologists Task Force on Sedation. Anesthesiology 1996;84:459-471.
  • Bell GD, McCloy RF, Charlton JE, et al. Recommendations for standards of sedation and patient monitoring during gastrointestinal endoscopy. Gut 1991 ;32:823-827.
  • Tan CC, Freeman JG. Throat spray for upper gastrointestinal endoscopy is quite acceptable to patients. Endoscopy 1996;28:277-282.
  • Campo R, Brullet E, Montserrat A, et al. Identification of factors that influence tolerance of upper gastrointestinal endoscopy. Eur J Gastroenterol Hepatol 1999; 11:201-204.
  • Wang CY, Ling LC, Cardosa MS, Wong AR, Wong HW. Hypoxia during upper gastrointestinal endoscopy with and without sedation and the effect of pre-oxygenation on oxygen saturation. Anaesthesia 2000,55:654- 658.
  • Iwao T, Toyonaga A, Harada H, et al. Arterial oxygen desaturation during non-sedated diagnostic upper gastrointestinal endoscopy. Gastrointest Endosc 1994;40:277-280.
  • Alcain G, Guillen P, Escolar A, Moreno M, Martin L. Predictive factors of oxygen desaturation during upper gastrointestinal endoscopy in non-sedated patients. Gastrointest Endosc 1998;48:143-147.
  • Yen D, Hu SC, Chen LS, et al. Arterial oxygen desaturation during emergent non-sedated upper gastrointestinal endoscopy in the emergency department. Am J Emerg Med 1997;15:644-647.
  • Tinnesen H, Puggaard L, Braagaard J, Ovesen H, Rasmussen V, Rosenberg J. Stress response to endoscopy. Scand J Gastroenterol 1999;54:629-631.
  • Schenck J, Müller CH, Lubbers H, Mahlke R, Lehnick D, Lankisch PG. Does gastroscopy induce myocardial ischemia in patients with coronary heart disease? Endoscopy 2000;32:373-376.
  • Wilcox CM, Faibicher M, Wenger HR, Shalek RA. Prevalence of silent myocardial ischemia and arrhythmias in patients with coronary heart disease undergoing gastrointestinal tract endoscopic procedures. Arch Intern Med 1993; 153:2325-2330.
  • Oei Lim VL, Ralkman CJ, Bartelsman JF, Res JC, Van Wezel HB. Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol. Eur J Anaesthesiol 1998; 15:535-543.
There are 15 citations in total.

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Authors

Demet Koç This is me

Rasim Gençosmanoğlu This is me

Orhan Şad This is me

Nurdan Tözün This is me

Publication Date December 3, 2016
Published in Issue Year 2001 Volume: 14 Issue: 2

Cite

APA Koç, D., Gençosmanoğlu, R., Şad, O., Tözün, N. (2016). THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY. Marmara Medical Journal, 14(2), 96-100.
AMA Koç D, Gençosmanoğlu R, Şad O, Tözün N. THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY. Marmara Med J. June 2016;14(2):96-100.
Chicago Koç, Demet, Rasim Gençosmanoğlu, Orhan Şad, and Nurdan Tözün. “THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY”. Marmara Medical Journal 14, no. 2 (June 2016): 96-100.
EndNote Koç D, Gençosmanoğlu R, Şad O, Tözün N (June 1, 2016) THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY. Marmara Medical Journal 14 2 96–100.
IEEE D. Koç, R. Gençosmanoğlu, O. Şad, and N. Tözün, “THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY”, Marmara Med J, vol. 14, no. 2, pp. 96–100, 2016.
ISNAD Koç, Demet et al. “THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY”. Marmara Medical Journal 14/2 (June 2016), 96-100.
JAMA Koç D, Gençosmanoğlu R, Şad O, Tözün N. THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY. Marmara Med J. 2016;14:96–100.
MLA Koç, Demet et al. “THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY”. Marmara Medical Journal, vol. 14, no. 2, 2016, pp. 96-100.
Vancouver Koç D, Gençosmanoğlu R, Şad O, Tözün N. THE EFFECTS OF SEDATION WITH INTRAVENOUS MIDAZOLAM IN 1 OO PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY. Marmara Med J. 2016;14(2):96-100.