Identification of factors that influence conscious sedation in gastrointestinal endoscopy.
Although several studies examined factors that influence conscious sedation, investigation was limited into the gender and age. The aim of this prospective study is to identify the clinical variables of successful conscious sedation during gastrointestinal endoscopy. A total of 300 subjects who underwent gastrointestinal endoscopy were enrolled in a prospective fashion. They completed a questionnaire to assess height, weight, drinking, smoking, education level, recent medication, past medical history, previous experience of conscious sedation, preprocedural anxiety, and apprehension about the procedure. Efficacy of sedation and amnesia were evaluated by the subject and the endoscopist. Amnesic and sedative effects were proportionally related with age (p<0.0001). Preprocedural anxiety level was higher in women (p=0.0062), younger subjects (p=0.035), slender subjects (p=0.041), and in those without previous experience of conscious sedation (p=0.0034). This anxiety level was also related to increased pain (p=0.0026) and alertness (p=0.0003) during the procedure. Lower dose of midazolam is needed for sedation in older subjects. Subjects with a high level of preprocedural anxiety such as women, younger subjects, slender subjects, and those without previous experience of conscious sedation should be sedated with great caution because generally, they complain of much more severe pain and alertness during the procedure.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sun-Young
SY
Lee
Hee Jung
HJ
Son
Ji Min
JM
Lee
Mun Hee
MH
Bae
Jae J
JJ
Kim
Seung Woon
SW
Paik
Byung Chul
BC
Yoo
Jong Chul
JC
Rhee
Seonwoo
S
Kim
D000367:Age Factors; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001835:Body Weight; D016292:Procedural Sedation; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D008874:Midazolam