[Midazolam versus dexmedetomidine for sedation for upper gastrointestinal endoscopy]. 2011

J A Vázquez-Reta, and M C Jiménez Ferrer, and A Colunga-Sánchez, and S Pizarro-Chávez, and A L Vázquez-Guerrero, and A R Vázquez-Guerrero
Servicio de Endoscopia, Hospital Central Universitario, Universidad Autónoma de Chihuahua, Chihuahua, México. dr_vazquezreta@hotmail.com

BACKGROUND The diagnostic upper gastrointestinal endoscopy (UGI) is a safe procedure although 50% to 60% morbidity and mortality due to cardiopulmonary complications. OBJECTIVE To compare safety and efficacy of dexmedetomidine vs. midazolam in UGI. METHODS We conducted a randomized controlled, double-blind, clinical trial to compare the two drugs. Patients with an indication of UGI were randomized to receive sedation with dexmedetomidine or midazolam during the procedure. We compared age, sex, physical status (ASA), body mass index (BMI), degree of sedation (Ramsay scale), recovery time and degree of satisfaction with the procedure. RESULTS Forty patients with an indication of UGI were included (20 in each arm). Both groups showed a similar distribution by sex, age, BMI and ASA physical status. The level of sedation was similar starting and ending the procedure according to the Ramsay scale. The dexmedetomidine group had a shorter recovery time (7.1 vs. 15.8 min, p <0.05) and satisfaction (9.9 vs. 9.0, p <0.05). Adverse effects occurred in similar proportions in both groups. CONCLUSIONS Midazolam and dexmedetomidine are suitable for endoscopic procedures of upper digestive tract. Dexmedetomidine offers shorter recovery time and better patient's satisfaction.

UI MeSH Term Description Entries
D006993 Hypnotics and Sedatives Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety. Hypnotic,Sedative,Sedative and Hypnotic,Sedatives,Hypnotic Effect,Hypnotic Effects,Hypnotics,Sedative Effect,Sedative Effects,Sedatives and Hypnotics,Effect, Hypnotic,Effect, Sedative,Effects, Hypnotic,Effects, Sedative,Hypnotic and Sedative
D008297 Male Males
D008874 Midazolam A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH. Dormicum,Midazolam Hydrochloride,Midazolam Maleate,Ro 21-3981,Versed,Hydrochloride, Midazolam,Maleate, Midazolam,Ro 21 3981,Ro 213981
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016145 Endoscopy, Digestive System Endoscopic examination, therapy or surgery of the digestive tract. Digestive System Endoscopic Surgical Procedures,Esophagogastroduodenoscopy,Surgical Procedures, Endoscopic, Digestive System,Digestive System Endoscopic Surgery,Endoscopic, Digestive System, Surgery,Endoscopic, Digestive System, Surgical Procedure,Procedure, Digestive System, Endoscopic, Surgical,Procedure, Endoscopic, Digestive System, Surgical,Procedures, Digestive System, Endoscopic, Surgical,Procedures, Endoscopic, Digestive System, Surgical,Surgery, Digestive System Endoscopic,Surgery, Endoscopic, Digestive System,Surgical Procedure, Endoscopic, Digestive System,Digestive System Endoscopies,Digestive System Endoscopy,Endoscopies, Digestive System,Esophagogastroduodenoscopies
D016292 Conscious Sedation A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines) Sedation, Conscious,Sedation, Moderate,Moderate Sedation

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