Original article
English
Salem M. Awami
Department of Medicine, Gastroenterology Unit, Faculty of Medicine, University of Omar Elmukhtar, Elbaida, Libya
JMJ 2008,Vol.8, No.3:199-202
Abstract
Aims: Endoscopy procedures are now used more often for diagnostic and/ or therapeutic purposes. Sedation is frequently used during these procedures. Premedication improves patient tolerance to the procedure, but potential side effects can occur. The aim of this study is to investigate the advantage and disadvantage of different sedation drugs compared with non-sedation. Methods and Results: A total of 54 subjects who were undergoing routine gastroscopy were randomly assigned to one of three groups. Midazolam, Diazepam, and normal saline group. Pulse, blood pressure, oxygen saturation, and time of examination start and finish were noted. A trained nurse filled in a ‘level of agitation’ using a visual analogue scale. Patients were given questionnaires which asked them to assess the comfort of the procedure on a visual analogue scale and they were asked a series of questions to determine what they could remember about the procedure. Discussion: Sedated patients were observed to be less agitated than the unsedated group (p<0.005), they reported comfortable gastroscopy (p<0.0001) and were significantly more amnesic (p<0.0001). The sedated patient were reported to encounter more difficulties such as desaturation. These difficulties arose in patients who are at the extremes of age, who have comorbid state, or who received large doses of intravenous benzodiazepines. Sedation for endoscopy should be individualized; to be given in fractionated dose, weight adapted, and at a lower dose for elderly patients and with comorbid state. Keywords: Endoscopy, Gastroscopy, Sedation, Benzodiazepines, Midazolam, Diazepam Link/DOI: http://www.jmj.org.ly/PDF/autumn2008/199.pdf