A Double-Blind Placebo Controlled Trial of Oral Midazolam As Premedication Before Flexible Sigmoidoscopy

Kuganeswaran, E; Wk, Clarkston; Pg, Cuddy; Sg, Quiason; Pk, Pandya; Wt, Dierenfeldt; Ss, Jonnalagadda; Oj, Smith; St, Chen

doi:10.1111/j.1572-0241.1999.01521.x

Cited by 27 publications

(6 citation statements)

References 13 publications

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“…There were no other minor or major respiratory side effects. Interestingly, despite higher dosing of midazolam administered in this study than in the nondermatologic literature, the incidence of respiratory side effects remained well below that reported by Beer et al, 30 Kuganeswaran et al, 32 and Mui et al 29 Paradoxical increase in pain in either of the midazolam groups was not observed. It is important to note that extensive monitoring of vital signs was used exclusively for data collection and is not required during routine MMS.…”

Section: Discussioncontrasting

confidence: 51%

“…Until now, dermatologists deduced the safety and efficacy of midalozam on the basis of wellestablished observations published mainly in the gastroenterology, dental, and surgical literature. [29][30][31][32] This study has conclusively proven oral midazolam to be safe and effective in reducing anxiety in the population of patients undergoing dermatologic surgery included in the study, particularly those with a higher baseline level of anxiety.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: Conclusions from randomized controlled and prospective studies

Ravitskiy

Phillips

Roenigk

et al. 2011

Journal of the American Academy of Dermatology

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 93%

The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: Conclusions from randomized controlled and prospective studies

Ravitskiy

Phillips

Roenigk

et al. 2011

Journal of the American Academy of Dermatology

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“…A double‐blind randomized study from Hong Kong showed that oral administration of 7.5 mg midazolam 20 min before upper gastrointestinal endoscopy reduced patient anxiety and increased patient satisfaction 42 . Similar results were reported with premedication before sigmoidoscopy 43 . On the other hand, a German study failed to show any benefit from oral administration of 1 mg lorazepam before ERCP, and premedicated patients actually required higher doses of propofol in the early stages of the procedures and higher overall doses of ketamine compared with controls 44 .…”

Section: Oral Pre‐medication Before Endoscopic Proceduresmentioning

confidence: 64%

Optimal sedation for gastrointestinal endoscopy: Review and recommendations

Thomson

Andrew²,

Jones

2010

J of Gastro and Hepatol

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Sedation practices for endoscopy vary widely. The present review focuses on the commonly used regimens in endoscopic sedation and the associated risks and benefits together with the appropriate safety measures and monitoring practices. In addition, alternatives and additions to intravenous sedation are discussed. Personnel requirements for endoscopic sedation are reviewed; there is evidence presented to indicate that non-anesthetists can administer sedative drugs, including propofol, safely and efficaciously in selected cases. The development of endoscopic sedation as a multi-disciplinary field is highlighted with the formation of the Australian Tripartite Endoscopy Sedation Committee. This comprises representatives of the Australian and New Zealand College of Anaesthetists, the Gastroenterological Society of Australia and the Royal Australasian College of Surgeons. Possible future directions in this area are also briefly summarized.

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“…In experienced hands, sigmoidoscopy is extremely safe [23] and only takes about 5 min to perform [22]. It causes only mild discomfort when a thin scope is used or with the aid of minor tranquilizers [24,25]. In light of the above, sigmoidoscopy is still an attractive method for detecting colon neoplasms [26,27].…”

Section: Introductionmentioning

confidence: 97%

A Risk Profile for Advanced Proximal Neoplasms on Diagnostic Colonoscopy

et al. 2008

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The capacity for colonoscopy is limited and a method to prioritize patients for diagnostic colonoscopy is needed in health care centers. A retrospective cross-sectional cohort study was carried out in county and community endoscopy centers, which included 1,065 county and 279 community patients aged > or = 40 years undergoing diagnostic colonoscopy. We constructed a risk profile for proximal advanced neoplasms on diagnostic colonoscopy at the county center based on the size of the regression coefficients for independent risk factors from logistic regression. An advanced neoplasm was defined as one of size > or = 1 cm or containing villous histology, high-grade dysplasia, or cancer. In our county colonoscopy population (n = 929 after exclusions), the stepwise logistic regression analysis identified age > or = 60 years (adjusted odds ratio [AOR]: 2.60; 95% confidence interval [CI]:1.14, 6.14), iron deficiency anemia (AOR: 4.74; 95% CI: 2.07, 11.34), and an advanced neoplasm in the recto-sigmoid (AOR: 6.01; 95% CI: 2.02, 16.00) as the statistically significant predictors of an advanced proximal neoplasm. In the county population, the prevalence rates of an advanced proximal neoplasm and proximal high-grade dysplasia/cancer in the low-risk group were 0.71% (95% CI: 0.15, 2.05) and 0.24% (95% CI: 0.01, 1.31), respectively. Avoiding colonoscopy in this group would increase the capacity for colonoscopy by 46% in the higher risk groups. In a disparate community population (n = 237 after exclusions), this scoring system had a goodness-of-fit test showing high concordance (P = 0.51). This clinical profile stratified the risk for an advanced neoplasm proximal to the sigmoid in patients undergoing diagnostic colonoscopy. It identified a large subset of low-risk patients.

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A Double-Blind Placebo Controlled Trial of Oral Midazolam As Premedication Before Flexible Sigmoidoscopy

Abstract: Oral midazolam significantly reduces anxiety and pain during flexible sigmoidoscopy as assessed by both patients and physicians. Oral midazolam is a safe and effective premedication before flexible sigmoidoscopy in patients who require or prefer sedation.

Cited by 27 publications

References 13 publications

The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: Conclusions from randomized controlled and prospective studies

The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: Conclusions from randomized controlled and prospective studies

Optimal sedation for gastrointestinal endoscopy: Review and recommendations

A Risk Profile for Advanced Proximal Neoplasms on Diagnostic Colonoscopy

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