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Midazolam, a water-soluble benzodiazepine, was compared with diazepam in fat emulsion (Diazemuls) as sedation for outpatient gastroscopy in a randomized double-blind fashion. Midazolam 0.05 mg kg-1 was found to be approximately equipotent to Diazemuls 0.15 mg kg-1. There were no differences concerning speed of recovery and all patients were considered ready for discharge after 2 h. Venous tolerance was good for both drugs. With the same degree of sedation, midazolam produced a higher frequency of amnesia (60% v. 7%; P less than 0.001) for the endoscopic procedure. Although the patients appeared to prefer midazolam to Diazemuls, this difference was significant only in patients who had not previously undergone gastroscopy (P less than 0.05). The high degree of amnesia with midazolam may be an advantage in sedation for unpleasant procedures like gastroscopy.
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