title: Efficacy of low and standard midazolam doses for gastroscopy. A randomized, double-blind study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of two different doses of intravenous midazolam (35 and 70 microg/kg) compared to placebo in patients undergoing gastroscopy.
  
  
  METHODS
  Sixty patients scheduled for diagnostic gastroscopy were selected according to factors previously reported to affect tolerance (Eur J Gastroenterol Hepatol 1999; 11:201-204) and were randomly assigned to receive premedication with midazolam 35 microg/kg iv, midazolam 70 microg/kg iv or placebo iv. Oxygen saturation was continuously monitored during the procedure. Patients' tolerance, time to discharge and post-sedative inconvenience were evaluated using visual analogue scales and a questionnaire.
  
  
  RESULTS
  Patients receiving either dose of midazolam showed better tolerance of gastroscopy than those receiving the placebo. Fewer patients receiving 70 or 35 microg/kg of midazolam were reluctant to undergo a further gastroscopy compared to those receiving the placebo (2, 1 and 9 patients respectively, P = 0.01). Compared to patients receiving midazolam 70 microg/kg, those receiving midazolam 35 microg/kg were discharged earlier (29.3+/-14.4 versus 43.1+/-12.4 min respectively, P < 0.001), experienced less post-sedative inconvenience (8 versus 15 patients slept for > 1 h at home respectively, P = 0.02), and suffered fewer clinically relevant desaturation episodes (< 90%) (0 versus 5 patients respectively, P = 0.04).
  
  
  CONCLUSIONS
  Low doses of intravenous midazolam (35 microg/kg) are adequate and safe when sedation is indicated for gastroscopy.
authors.affiliation: Digestive Endoscopy Unit (SDI), CS Parc Tauli, Sabadell, Spain. rcampo@cspt.es
authors.forename: R
authors.initials: R
authors.lastname: Campo
authors.forename: E
authors.initials: E
authors.lastname: Brullet
authors.forename: A
authors.initials: A
authors.lastname: Montserrat
authors.forename: X
authors.initials: X
authors.lastname: Calvet
authors.forename: L
authors.initials: L
authors.lastname: Donoso
authors.forename: J M
authors.initials: JM
authors.lastname: Bordas
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004311:Double-Blind Method; D005260:Female; D005773:Gastroscopy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D011292:Premedication; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam