title: Effects of midazolam or tramadol premedication on early cognitive function in endoscopic retrograde cholangiopancreatography (ERCP): A randomized, controlled, double-blind study.
abstract: OBJECTIVE
  To evaluate the sedative efficacy and effects on early period cognitive function of premedication in endoscopic retrograde cholangiopancreatography (ERCP).
  
  
  METHODS
  Forty patients (18-70 years; American Society of Anesthesiology risk category I-III) undergoing elective ERCP were randomized to receive oral premedication with 0.15 mg/kg midazolam or 1 mg/kg tramadol. Cognitive function was determined by mini-mental test (MMT). Target scores for effective sedation were determined as a Bispectral index score of 70-90 and modified Ramsay Sedation Scale score (mRSS) of 2-4.
  
  
  RESULTS
  Global MMT score was not significantly different between treatment groups at 60 min post-ERCP. A significant deterioration in the MMT subcategory of recall was determined in with midazolam versus tramadol. Level of sedation (mRSS) was higher in with midazolam compared with tramadol reaching statistical significance at 30 min after drug administration.
  
  
  CONCLUSIONS
  Although more effective sedation was obtained with midazolam in patients undergoing ERCP, there was a dysfunction in memory recall. It was concluded, however, that early cognitive functions were generally preserved with both drugs.
authors.affiliation: Department of Anesthesiology and Critical Care, Karadeniz Technical University, Faculty of Medicine, TRABZON, Turkey hulyaulusoy.md@gmail.com.
authors.forename: Hulya
authors.initials: H
authors.lastname: Ulusoy
authors.affiliation: Umut Hospital, Anesthesiology, ORDU, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Coskun
authors.affiliation: Department of Gastroenterology, Karadeniz Technical University, Faculty of Medicine, TRABZON, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arslan
mesh_terms: D000762:Anesthesia Recovery Period; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003071:Cognition; D016292:Procedural Sedation; D056805:Consciousness Monitors; D003710:Demography; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D017060:Patient Satisfaction; D010820:Physicians; D011292:Premedication; D013997:Time Factors; D014147:Tramadol / Q000627:therapeutic use*; D055986:Vital Signs
chemical_list: D014147:Tramadol; D008874:Midazolam
keywords: ERCP; Premedication; cognitive; midazolam; tramadol