A Randomized, Prospective, Double-Blind Comparison of Midazolam (Versed) and Emulsified Diazepam (Dizac) for Opioid-Based, Conscious Sedation in Endoscopic Procedures

Houten, Jeffrey S Van; Crane, Steven A; Janardan, Srinivas K; Wells, Kathy

doi:10.1111/j.1572-0241.1998.00170.x

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…Our results indicate that orally administered midazolam and diazepam produce equivalent sedation in pediatric patients undergoing upper endoscopy procedures. Similar findings have been reported in studies evaluating acute sedation in both adults and children when these drugs are administered at equipotent doses (2–3,8–19). This study is the first to compare the efficacy and safety of orally administered midazolam and diazepam for pre‐procedural sedation in children undergoing endoscopy.…”

Section: Discussionsupporting

confidence: 84%

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

Martinez,

Sutters,

Waite

et al. 2002

J. pediatr. gastroenterol. nutr.

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ObjectivesThis study was performed to compare the effects of oral midazolam and oral diazepam, administered with intravenous (IV) meperidine, on pre‐procedural, procedural, and post‐procedural sedation and recovery in children undergoing diagnostic upper endoscopy. The costs of pre‐procedure sedation were compared for the two benzodiazepines.MethodsA randomized, double‐blind study was conducted in 154 children (mean age 96.73 ± 59.34 months, 53% male) undergoing endoscopy. Oral midazolam (0.5 mg/kg, maximum dose of 20 mg) or oral diazepam (0.3 mg/kg, maximum dose of 10 mg) was given before IV insertion, and with IV meperidine (2 mg/kg, maximum dose of 100 mg) given to all patients just before upper endoscopy. Further “rescue” midazolam doses (to a maximum cumulative dose of 5 mg) were given as needed to achieve a pre‐procedure sedation score of ≥2. All patients received intravenous propofol for procedural sedation. Patients were evaluated for the efficacy and safety of pre‐procedural sedation, sedation during upper endoscopy, and recovery following completion of the procedure.ResultsThere were no significant differences between study groups for level of pre‐procedural sedation, need for midazolam rescue in endoscopy, effectiveness of procedural sedation, occurrence of adverse events, and recovery parameters.ConclusionsOral 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.

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Section: Discussionsupporting

confidence: 84%

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

Martinez,

Sutters,

Waite

et al. 2002

J. pediatr. gastroenterol. nutr.

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“…Since April 1998, a postsedation questionnaire has been introduced in our hospital. The questionnaire was previously described by Van Houten et al [13], and was designed to evaluate the memory and/or pain experience of the child during the procedure. The questionnaire includes the following questions:…”

Section: Assessment Of Sedation Efficacymentioning

confidence: 99%

Propofol Sedation for Endoscopic Procedures in Children

Elitsur¹,

Blankenship²,

Lawrence³

2000

Endoscopy

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“…It has been claimed that midazolam (at a dosage of 0.035 -0.05 mg/kg body weight) has a number of potential advantages over diazepam, such as a shorter elimination half-life (with metabolites essentially devoid of sedative activity), better anterograde amnesia, and water solubility. However, these data have not been fully confirmed by two controlled studies in patients undergoing esophagogastroduodenoscopy or colonoscopy who were randomly assigned to received emulsified diazepam or midazolam [21,22]. Neither the physicians, nurses, nor the patients were able to detect any difference between the drugs with regard to the length of time to sedation, total procedure time, patient tolerance, cooperation and recovery time, which were similar in the two groups.…”

Section: Benzodiazepines and Their Antagonistsmentioning

confidence: 89%

Premedication, Preparation, and Surveillance

Lazzaroni

Bianchi-Porro²

1999

Endoscopy

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During the last two years, the well-known positive role of benzodiazepines (midazolam and diazepam) in conscious sedation, both in adults and pediatric patients, has been confirmed by several studies. However, problems concerning the role of sedation and analgesia in nonoperative endoscopy are still a matter of debate. Particular attention has focused on attempts to identify the "ideal candidate" for conscious sedation, and on the importance of providing patients with information before the procedure, which should be matched to each patient's style of coping. Before detailed information about a medical procedure is given blindly, the clinician should investigate whether such information will benefit or adversely affect the patient receiving it. An important aspect of the sedation procedure is the prevention of hypoxia and cardiopulmonary complications. Recent endoscopic experience has provided little additional information concerning the well-known risk of oxygen desaturation during conscious sedation. Performing endoscopy in sedated patients reduces, but does not eliminate, the risk of hypoxia. Some independent variables capable of predicting severe desaturation have been recognized, such as basal SaO2 < 95%, respiratory disease, more than one attempt needed for intubation, emergency procedure, and an American Society of Anesthesiologists score of III or IV. As far as preparation is concerned, some light has been cast by a meta-analysis of available studies concerning the role of sodium phosphate and polyethylene glycol electrolyte lavage solution (PEG-ELS). The former preparation has been found to be as effective and less costly compared with the latter. In particular, sodium phosphate may be preferable in patients without cardiovascular or renal co-morbidity, and in those with a tendency to develop nausea or bloating.

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A Randomized, Prospective, Double-Blind Comparison of Midazolam (Versed) and Emulsified Diazepam (Dizac) for Opioid-Based, Conscious Sedation in Endoscopic Procedures

Cited by 7 publications

References 15 publications

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

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

Propofol Sedation for Endoscopic Procedures in Children

Premedication, Preparation, and Surveillance

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