Comparison of sedative recovery time after midazolam versus diazepam administration

Ariano, Robert E.; Kassum, Diamond A.; Aronson, Kristan J.

doi:10.1097/00003246-199409000-00022

Cited by 45 publications

(5 citation statements)

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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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“…Interestingly there is evidence in the literature that the mechanism of action of benzodiazepines is modulated by the action of sexual hormones and that testosterone plays a relevant role. 18 It has been suggested that the elimination half-lives of benzodiazepines do not necessarily correspond with their sedative pharmacodynamic effects 19 and this has lead some to advocate continuous infusion of flumazenil for 2 hours to ensure that patients are free from resedation following induction of anaesthesia with midazolam. 20 Certainly after the smaller doses required for conscious sedation, there is no evidence that this is required.…”

Section: Discussionmentioning

confidence: 99%

The effects of midazolam and flumazenil on psychomotor function and alertness in human volunteers

Coulthard¹,

Sano²,

Thomson³

et al. 2000

Br Dent J

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“…Because of the greater potency and slower clearance of lorazepam, emergence from short-term sedation (1-2 days) with lorazepam may be longer than with midazolam. Diazepam has a prolonged duration of action due to saturation of peripheral tissues and active metabolites that can accumulate in patients with renal insufficiency (185). Diazepam has a prolonged duration of action due to saturation of peripheral tissues and active metabolites that can accumulate in patients with renal insufficiency (185).…”

Section: Agitation and Sedationmentioning

confidence: 99%

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Barr

Fraser

Puntillo

et al. 2013

Critical Care Medicine

3,187

3,013

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Comparison of sedative recovery time after midazolam versus diazepam administration

Cited by 45 publications

References 0 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

The effects of midazolam and flumazenil on psychomotor function and alertness in human volunteers

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

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