A Comparison of Oral Diazepam Versus Midazolam, Administered With Intravenous Meperidine, as Premedication to Sedation for Pediatric Endoscopy

Martínez, José Manuel Lavié; Sutters, Kimberly A.; Waite, Steven; Davis, J. L.; Medina, E; Montano, Nancy; Merzel, David; Marquez, Carol

doi:10.1097/00005176-200207000-00012

Cited by 21 publications

(28 citation statements)

References 23 publications

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“…EGD procedure was performed by pediatric endoscopist, using EG530 WR (diameter 9.4 mm; Fujinon, Tokyo, Japan). Effectiveness of sedation was assessed by the endoscopist using modified Ramsay sedation scale (RSS) [10]. Scoring in RSS scale is ranked in 6 points based on patient's reaction and cooperation.…”

Section: Methodsmentioning

confidence: 99%

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

Baştürk

Artan

Yılmaz

2017

Pediatr Gastroenterol Hepatol Nutr

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PurposeOur aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children.MethodsThe endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion.ResultsSedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (p=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (p=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (p=0.019) and the difference was statistically significant.ConclusionThe study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.

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Section: Methodsmentioning

confidence: 99%

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

Baştürk

Artan

Yılmaz

2017

Pediatr Gastroenterol Hepatol Nutr

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“…Esophageal, gastric or duodenal biopsies were taken when necessary during the procedure. Effectiveness of sedation during the procedure was assessed using a modified Ramsay sedation score (RSS) [ 3 ] ( Table 1 ). Under this system, patients are classified from 1 to 6 on the basis of their response to stimuli.…”

Section: Methodsmentioning

confidence: 99%

“…The most frequently employed sedatives are benzodiazepines [ 3 ]. These enhance the inhibitor effect of gamma-amino butyric acid (GABA) by binding between alpha and gamma subunits on GABA receptors.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Low Dose Ketamine and Midazolam Combination for Diagnostic Upper Gastrointestinal Endoscopy in Children

Akbulut

Çakır

2015

Pediatr Gastroenterol Hepatol Nutr

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PurposeWe aimed to analyze the effectiveness and safety of low-dose midazolam and ketamine combination for upper gastrointestinal endoscopy (UGIE) in children.MethodsThe study included the children (n=425, 10.78±3.81 years) who underwent UGIE for diagnostic purpose during 1 year period. All children were sedated with low dose midazolam (0.1 mg/kg) and ketamine (0.5 mg/kg) intravenously. Effectiveness of the sedation and complications during the procedure and recovery period were recorded.ResultsEndoscopic procedure was successfully completed in 414 patients (97.4%; 95% confidence interval, 95.8-98.9). Mean±standard deviation (SD) duration of procedure was 6.36±1.64 minutes (median, 6.0 minutes; range, 4-12 minutes). Minor complications occurred during the procedure in 39.2% of the patients. The most common complication was increased oral secretion (33.1%). No major complications were observed in any patient. Age and Ramsay sedation scores of patients with complications during the procedure were lower than the others (9.49±4.05 years vs. 11.61±3.43 years, p=0.002 and 2.10±1.46 vs. 4.37±1.16, p=0.001). Mean recovery time was 22 minutes (range, 10-90 minutes; mean±SD, 25±12.32 minutes). Minor complications developed during recovery in 60.1% of the patients. The most common complication was transient double vision (n=127, 30.7%). Emergence reaction was observed in 5 patients (1.2%).ConclusionThe procedure was completed with high level of success without any major complication in our study. Combination of low-dose midazolam and ketamine is a suitable sedation protocol for pediatric endoscopists in UGIE.

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“…91 For those using deep sedation, most protocols combine benzodiazepines, propofol, or meperidine given intravenously. [92][93][94][95][96][97][98][99] The administration of propofol is reserved to anesthesiologists in some countries (France, UK) or may be given by nonanesthesiology trained physicians in other countries (USA). IV ketamine has also been used for upper gastrointestinal endoscopy.…”

Section: Are Therapeutic Interventions Supported By Efficacy and Safementioning

confidence: 99%

Procedural pain in children: evidence-based best practice and guidelines

Murat

Gall

Tourniaire

2003

Regional Anesthesia and Pain Medicine

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A Comparison of Oral Diazepam Versus Midazolam, Administered With Intravenous Meperidine, as Premedication to Sedation for Pediatric Endoscopy

Abstract: Oral midazolam and diazepam, in conjunction with IV administration of meperidine, provide comparable, effective, and safe premedication for children undergoing upper endoscopy. The cost of midazolam was substantially higher than diazepam.

Cited by 21 publications

References 23 publications

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

Efficacy and Safety of Low Dose Ketamine and Midazolam Combination for Diagnostic Upper Gastrointestinal Endoscopy in Children

Procedural pain in children: evidence-based best practice and guidelines

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