Superiority of split dose midazolam as conscious sedation for outpatient colonoscopy.
OBJECTIVE
To elucidate the efficacy and safety of a split dose of midazolam in combination with meperidine for colonoscopy.


METHODS
Eighty subjects undergoing outpatient colonoscopy were randomly assigned to group A or B. Group A (n = 40) received a split dose of midazolam in combination with meperidine. Group B (n = 40) received a single dose of midazolam in combination with meperidine. Outcome measurements were level of sedation, duration of sedation and recovery, degree of pain and satisfaction, procedure-related memory, controllability, and adverse events.


RESULTS
Group A had a lower frequency of significant hypoxemia (P = 0.043) and a higher sedation score on withdrawal of the endoscope from the descending colon than group B (P = 0.043). Group B recovered from sedation slightly sooner than group A (P < 0.002). Scores for pain and memory, except insertion-related memory, were lower in group A one week after colonoscopic examination (P = 0.018 and P < 0.030, respectively). Poor patient controllability was noted by the endoscopist and nurse in group B (P = 0.038 and P = 0.032, respectively).


CONCLUSIONS
Split dose midazolam in combination with meperidine resulted in a safer, more equable sedation status during colonoscopic examination and a reduction in procedure-related pain and memory, but resulted in longer recovery time.
Lee
Hyuk
H
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kim
Jeong Hwan
JH
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D003113:Colonoscopy / Q000009:adverse effects*; D016292:Procedural Sedation / Q000379:methods*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use*; D008874:Midazolam / Q000627:therapeutic use*; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008614:Meperidine; D008874:Midazolam