Korean J Gastrointest Endosc > Volume 19(1); 1999 > Article

Korean Journal of Gastrointestinal Endoscopy 1999;19(1): 33-40.

대장 내시경 검사시 전처치제로서 Midazolam 단독 사용에 관한 연구 ( Midazolam as a Premedication for Colonoscopy )

왕길상, 박영숙, 황의경, 황인후, 문찬희, 이근만, 문영수, 김혜랑 (Kil Sang Wang, Young Sook Park, Eui Kyung Whang, In Hoo Whang, Chan Hi Moon, Keum Man Lee, Young Soo Moon and Hye Rang Kim)

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. (Korean J Gastrointest Endosc 18: 33 ∼40, 1999)

Key Words: Midazolam, Colonoscopy, Trieger test