title: [Acceptability of high colonoscopy using different premedication--a comparison of the effect of midazolam versus midazolam and pethidine from the viewpoint of the patient and the physician].
abstract: Invasive endoscopic procedures such as total colonoscopy result in a better patient acceptance, the less discomfort they cause. Therefore a premedication for total colonoscopy is often required. In a prospective, double-blind, placebo-controlled clinical study of 132 patients examined by one experienced endoscopist we compared two premedication schedules: midazolam (mean 5.2 mg i.v.) versus midazolam (mean 4.8 mg) plus pethidin (50 mg). We found that the combination midazolam plus pethidin provides a deeper and more reliable sedation and analgesia than midazolam alone. The combination of both drugs caused also more anterograde amnesia. It was also shown, that the endoscopist scored a higher degree of patient's pain during the examination than the patient did himself. No more negative side-effects such as decrease of arterial partial pressure of oxygen or cardiopulmonary complications were found using the combination of both drugs; they provided to be safe without added risk of hypoxia. Thus, the combination of both drugs can be given as premedication for total colonoscopy.
authors.affiliation: IV. Medizinische Klinik, Schwerpunkt Gastroenterologie, des Klinikums Mannheim, Universität Heidelberg, Mannheim.
authors.forename: U B
authors.initials: UB
authors.lastname: Ehrle
authors.forename: B
authors.initials: B
authors.lastname: Horschler
authors.forename: M V
authors.initials: MV
authors.lastname: Singer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000523:psychology; D016292:Procedural Sedation; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000009:adverse effects; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011292:Premedication; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D008614:Meperidine; D008874:Midazolam