Cardiorespiratory compromise under conscious sedation during upper gastrointestinal endoscopy.

OBJECTIVE

To compare the cardiorespiratory effects of benzodiazepine and midazolam used for sedation in patients undergoing upper gastrointestinal endoscopy with cardiorespiratory changes in the non-sedated patients.

STUDY DESIGN

Comparative, randomized, single blind study. Duration and Setting: Department of Medicine at Government Medical College and Hospital, Chandigarh, India, from January to July 2000.

PATIENTS AND METHODS

A total of 252 adult patients without previous cardiorespiratory co-morbidity, undergoing upper gastrointestinal endoscopy were recruited. They were randomly allocated in to group I (placebo with saline administration), group II (diazepam administered) and group III (midazolam administered). The pulse rate, blood pressure, ECG and peripheral oxygen saturation (SpO2) was noted at baseline, after pre-medication, during endoscopy and postendoscopy. Statistical analysis was done by paired t-test, Chi-square test and ANOVA as applicable.

RESULTS

There was no difference in baseline record of the three groups. Significant fall in SpO2 was noted in all the groups, more marked in the sedated one during endoscopy. Tachycardia developed in all the three groups and settled within 5 minutes of endoscopy. Blood pressure remained more stable in the sedated group. ECG changes included atrial and ventricular premature contraction in all the three groups.

CONCLUSION

Endoscopy is a safe procedure where cardiorespiratory complication are minimized in non-sedated patients when appropriately selected.