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 20 November 2017

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News

Sedation with intranasal midazolam during upper GI endoscopies is associated with fewer side effects than when administering midazolam intravenously

Writing in the August edition of The Journal of Clinical Gastroenterology, scientists describe the results of a controlled clinical study examining the use of intranasal midazolam for sedation in upper gastrointestinal endoscopy.

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A total of 81 patients with a mean age of 37 years were recruited into the study. All patients were undergoing upper gastrointestinal endoscopy for various reasons.

The study population was split into 3 subgroups according to the sedation regimen they were to follow.

In the first group (n = 30) patients received intranasal midazolam, while in the second group (n = 28) intravenous midazolam was administered for sedation.

The third group of patients (n = 23) acted as controls and received placebo before the procedures.

All patients were monitored using a pulse oximeter with an interval of 5 minutes until the 45th minute after the procedure, for arterial oxygen saturation, heart rate, systolic and diastolic arterial blood pressure, and respiratory rate.

Intranasal midazolam - "patients undergoing upper GI endoscopy might not even need monitoring"
Journal of Clinical Gastroenterology

Efficacy of sedation, amnesia, side effects and patient preferences were all evaluated using a patient questionnaire.

This indicated a preference among patients for intravenous drug administration over the intranasal route.

In terms of levels of amnesia however, intranasal (IN) midazolam was found to be almost equally as effective as intravenous (IV) midazolam.

Furthermore, significantly fewer side effects were associated with the IN route of drug application as compared to the IV route.

Commenting on the findings, one of the report authors, Dr Oya Uygur-Bayramiçli, of Kartal State Hospital, Istanbul, Turkey, said that the intranasal application of midazolam for gastrointestinal endoscopy appeared to be an interesting alternative to the IV route.

Dr Uygur-Bayramiçli continued, saying that this was particularly true when considering that the usage of IV midazolam might be limited because of its potentially serious side effects.

"In contrast to the IV application," the doctor continued, "the IN route may not even necessitate the monitoring of the patient during upper gastrointestinal endoscopy."

J Clin Gastroenterol 2002; 35(2): 133-137
09 August 2002

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