A team from St. Louis, Missouri, USA, assessed the effect of midazolam on the hypertensive sphincter of Oddi.
A total of 36 patients who presented with recurrent abdominal pain resulting from sphincter of Oddi dysfunction were included in the study population.
Sphincter of Oddi manometry was performed in standard fashion in the nonrandomized, prospective trial.
Manometric tracings were interpreted while the investigator was blinded to treatment allocation.
Some 18 patients in the test group received 2 mg of midazolam intravenously, whereas the 18 patients in the control group received saline solution intravenously.
The researchers measured manometric parameters before and 3 minutes after the intravenous infusion.
| Use of midazolam in manometry could change patient diagnosis and management.
| Gastrointestinal Endoscopy |
Changes in manometric findings, before and after the administration of saline solution and midazolam, were compared.
It was found that midazolam caused a significant reduction in basal sphincter of Oddi pressure (24 mm Hg), as compared with saline solution.
Diagnostic concordance (normal vs abnormal) between the basal sphincter pressure before and after midazolam was seen in only 77% of patients.
Dr Ali Fazel, of the Saint Louis University School of Medicine and St. Mary's Health Center, said on behalf of the authors, "Midazolam significantly altered sphincter of Oddi motility.
"The decrease in sphincteric pressures would have altered diagnosis and management in 4 of 18 patients."
"Midazolam should not be used during sphincter of Oddi manometry," he concluded.