Midazolam as a Premedication for Colonoscopy

Wang, Kil Sang; Park, Young Sook; Whang, Eui Kyung; Whang, In Hoo; Moon, Chan Hi; Lee, Keum Man; Moon, Young Soo; Kim, Hye Rang

Abstract

BACKGROUND
As the frequency of colonoscopic approaches increases, we need a less painful premedication for colonoscopy. We used midazolam as a premedication agent. It has more rapid onset of action than that of diazepam and its duration is shorter. The purpose of this study was to examine the clinical application of midazolam. METHODS: Fifty patients underwent colonoscopies. An average dose of midazolam, 0.07 mg/kg, was given to patients intravenously as premedication. We measured systolic and diastolic blood pressures, pulse rates, respiratory rates, and oxygen saturation (SaO2) using pulse oxymetry before and after the injection. A Trieger test was accomplished before and after the procedures. We examined the levels of consciousness with verbal and physical stimulation during the colonoscopy. The examiners noted the degree of amnesia and pain after colono-scopy. We examined the patients' satisfaction and endoscopists' assessments. RESULTS: 1) Systolic, diastolic blood pressures and respiratory rates showed no significant changes. But, pulse rates increased meaningfully at 15 minutes after the injection of midazolam (p <0.05). 2) The Trieger test showed meaningfully increased numbers of missed dots after the injection of midazolam. 3) The levels of consciousness during the test showed alertness in 22 patients (44%), drowsy mentality in 22 patients (44%) and stuporous mentality in 6 patient (12%). 4) The degree of amnesia after examination showed recall in 26 patients (52%), partial recall in 10 patients (20%) and total amnesia in 14 patients (28%). 5) Forty-five patients (90%) acknowledged this procedures to be more comfortable than previous procedures. CONCLUSIONS: Midazolam stabilized vital signs and oxygen saturation, therefore midazolam can be used safely as premedication for colonoscopy. Thirty-six patients (72%) recalled the procedures totally or partially. But, the relief of pain compared favorably to the degree of amnesia. We concluded that mida-zolam (0.07 mg/kg) was the safe and effective premedication for colonoscopy.