Midazolam Sedation for Upper Gastrointestinal Endoscopy in Older Persons: A Randomized, Double‐Blind, Placebo‐Controlled Study

Christe, C.; Janssens, Jean–Paul; Armenian, Berj; Herrmann, François; Vogt, Nicole P.

doi:10.1111/j.1532-5415.2000.tb02628.x

Cited by 64 publications

(45 citation statements)

References 27 publications

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“…41,42 In addition, reduced respiratory depression and superior patient satisfaction has been demonstrated with midazolam compared with diazepam. 43 Unfortunately, however, the potency of midazolam seems to increase in elderly patients (≥60 years), resulting in an increased potential for respiratory depression. 42 Therefore, the dose of midazolam should be decreased and the intervals between administrations should be increased in these patients.…”

Section: Reviews Benzodiazepinesmentioning

confidence: 99%

How best to approach endoscopic sedation?

Müller

Wehrmann

2011

Nat Rev Gastroenterol Hepatol

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Sedation is the drug-induced reduction of a patient's consciousness. The aim of sedation in endoscopic procedures is to increase the patient's comfort and to improve endoscopic performance, especially in therapeutic procedures. The most commonly used sedation regimen for conscious sedation in gastrointestinal endoscopy is still the combination of benzodiazepines with opioids. However, the use of propofol has increased enormously in the past decade and several studies show advantages of propofol over the traditional regimes in terms of faster recovery time. It is important to be aware that the complication rate of endoscopies increases when sedation is used; therefore, a thorough risk evaluation before the procedure and monitoring during the procedure must be performed. In addition, properly trained staff and emergency equipment should be available. The best approach to sedation in endoscopy is to choose a sedation regimen for the individual patient, tailored according to the clinical risk assessment and the anxiety level of the patient, as well as to the type of planned endoscopic procedure.

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Section: Reviews Benzodiazepinesmentioning

confidence: 99%

How best to approach endoscopic sedation?

Müller

Wehrmann

2011

Nat Rev Gastroenterol Hepatol

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“…While some experts are against sedation due to its potential adverse events and to the acceptable tolerance to endoscopic procedures by elderly patients (12,21), several studies support safety of sedation in the geriatric population (5,18,(22)(23)(24)(25)(26). Further, it has been recently published that detection rate of neoplastic lesions (its prevalence increases as we get older) is partially depended on the use of sedation(33) so necessity for sedation in endoscopic procedures is strengthened, specially in the geriatric population.…”

Section: Discussionmentioning

confidence: 99%

“…These patients are highly susceptible to hypoventilation and apnea due to changes in the pharmacokinetic and the pharmacodynamic profile. Thus, it has been proved that patients > 90 years present similar plasma propofol levels to younger controls although dose in older patients was 40% lower (18,20). Though this group of patients shows better tolerance to endoscopic procedures without sedation (18,21), several studies suggest that conscious and deep sedation are safe (5,18,(22)(23)(24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it has been proved that patients > 90 years present similar plasma propofol levels to younger controls although dose in older patients was 40% lower (18,20). Though this group of patients shows better tolerance to endoscopic procedures without sedation (18,21), several studies suggest that conscious and deep sedation are safe (5,18,(22)(23)(24)(25)(26). Moreover, some authors have suggested that the use of propofol by the endoscopy unit personnel may be efficient and safe even in elderly patients (5,(26)(27)(28)(29)(30), but the use of continuous propofol infusion in these group of patients is not reported.…”

Section: Introductionmentioning

confidence: 99%

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Safety of continuous propofol sedation for endoscopic procedures in elderly patients

Martínez

Aparicio

Ruiz

et al. 2011

Rev. esp. enferm. dig.

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Objective: to evaluate safety of continuous propofol sedation in elderly patients who undergo endoscopic procedures and investigate risk factors to develop complications in the geriatric population.Material and methods: patients who received endoscopistdirected propofol sedation were classified into two groups according to age. Group I: > 80 years; Group II: < 80 years. Propofol was administered by continuous intravenous infusion to achieve deep sedation. Arterial oxygen saturation, heart rate, blood pressure, and electrocardiographic records were monitored during the procedure. Therapy and complications secondary to sedation were recorded.Results: one thousand two-hundred and ninety-five endoscopic procedures (gastroscopies, colonoscopies and endoscopic ultrasonographies) were included. The dose of propofol was lower and therapy was more frequently performed in Group I. There were no differences between sedation-related complications in both groups (Group I: 15.4%; Group II: 14%; p, NS). Patients in Group I showed greater tendency to develop severe oxygen desaturation in the colonoscopy and endoscopic ultrasonography procedures. In the univariate analysis, a higher dose of propofol was associated with the appearance of complications (157.4 ± 84.4 vs. 121.3 ± 89.6 mg) in elderly patients but it was not associated with severe oxygen desaturation.Conclusions: continuous propofol sedation during endoscopic procedures in elderly patients > 80 years is as safe as in younger patients.

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“…No obstante, la literatura indica que la mayoría de las complicaciones durante el examen endoscópico se relacionan con la sedación 4 . Particularmente el riesgo de depresión cardiopulmonar ha sido constatada en pacientes de edad avanzada 5,6 .…”

Section: Introductionunclassified

Ansiedad en gastroscopias: Comparación de dos intervenciones de enfermería en gastroscopias sin sedación.

García-Sierra

Sáez

Sánchez

2013

eglobal

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Midazolam Sedation for Upper Gastrointestinal Endoscopy in Older Persons: A Randomized, Double‐Blind, Placebo‐Controlled Study

Abstract: Under adequate surveillance, the benefits in terms of tolerance to the procedure of low-dose midazolam for upper gastrointestinal endoscopic sedation outweigh the risks in older people.

Cited by 64 publications

References 27 publications

How best to approach endoscopic sedation?

How best to approach endoscopic sedation?

Safety of continuous propofol sedation for endoscopic procedures in elderly patients

Ansiedad en gastroscopias: Comparación de dos intervenciones de enfermería en gastroscopias sin sedación.

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