EVIDENCE LIBRARY
Midazolam and Endoscopy Discomfort: Patient and Operator Factors Also Mattered
A cross-sectional endoscopy study associated sedation with less discomfort while also identifying patient and endoscopist differences.
A cross-sectional endoscopy study associated sedation with less discomfort while also identifying patient and endoscopist differences.
A multifactorial outcome
The study included 1,715 screening upper-endoscopy patients. Midazolam, pethidine, and their combination were associated with lower discomfort in adjusted analyses. Age, sex, height, smoking, hiatal hernia, and the individual endoscopist were also associated with reported discomfort.
Association is not a head-to-head efficacy trial
Sedation selection was not randomized, and the measured experience reflected both the procedure and treatment context. Patient preference, anticipated difficulty, and other unmeasured factors could influence the association. The results cannot establish that one patient’s discomfort was caused by an inadequate midazolam dose or prove a universal best regimen. Their value is showing that discomfort is not explained by a medication entry alone. Record review should consider the patient’s baseline experience, procedure details, actual administration, and timing of the reported outcome.
Source paper
Original analysis of the supplied journal article, identified as PMC7177206.