CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Donnelly, M. B.
Right arrow Articles by Daly, D. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Donnelly, M. B.
Right arrow Articles by Daly, D. S.

Canadian Journal of Anesthesia, Vol 41, 1161-1165, Copyright © 1994 by Canadian Anesthesiologists' Society

ARTICLES

Sedation for upper gastrointestinal endoscopy: a comparison of alfentanil-midazolam and meperidine-diazepam

MB Donnelly, WA Scott and DS Daly
Department of Anaesthesia, Montreal General Hospital, Quebec, Canada.

The authors studied the efficacy and cost of substituting sedation using midazolam and alfentanil for the existing regimen of diazepam and meperidine in patients requiring upper gastrointestinal endoscopy. Sixty consenting subjects were randomized to receive either meperidine 50 mg with diazepam approximately 90 micrograms.kg-1 (Group D) or alfentanil 250 micrograms with midazolam approximately 50 micrograms.kg-1 (Group M). Endoscope insertion time, patient acceptance, apnoeic or desaturation episodes were noted by a physician observer. Pulse oximetry was used to monitor heart rate and oxygen saturation (SpO2) during endoscopy. Subjects performed four-choice reaction time (4CRT) tests before, 30 and 60 min after endoscopy, and were assessed for nausea or dizziness and their ability to stand and walk. During endoscopy, insertion time was shorter (84 +/- 45 sec vs 122 +/- 83 sec, P < 0.03) and fewer aversive movements occurred (0.4 +/- 0.6 vs. 1.7 +/- 2.4, P < 0.005) in Group M than Group D. No subject in either group suffered any apnoea or prolonged desaturation requiring supplemental oxygen. Irrespective of treatment group, greater decreases in SpO2 (6.1 +/- 3.4% vs 3.6 +/- 2.2% P < 0.001) occurred in subjects > 45 yr of age than in subjects < or = 45 yr. During recovery 4CRT values at 30 min after endoscopy were longer (723 +/- 226 msec vs 594 +/- 139 msec, P < 0.005) in Group M than in Group D but not after 60 min. It was concluded that the small differences in endoscopy conditions and greater sedation during the first 30 min of recovery did not justify the additional cost of using midazolam and alfentnil.(ABSTRACT TRUNCATED AT 250 WORDS)


This article has been cited by other articles:


Home page
 PediatricsHome page
R. I. Parker, R. A. Mahan, D. Giugliano, and M. M. Parker
Efficacy and Safety of Intravenous Midazolam and Ketamine as Sedation for Therapeutic and Diagnostic Procedures in Children
Pediatrics, March 1, 1997; 99(3): 427 - 431.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1994 by the Canadian Anesthesiologists' Society.