Rafeey Mandana, Ghojazadeh Morteza, Feizo Allah Zadeh Hosain, Majidi Hamideh
Department of Pediatrics, Liver and Gastrointestinal Diseases Research Center, Iran.
Pediatr Int. 2010 Apr;52(2):191-5. doi: 10.1111/j.1442-200X.2009.02936.x. Epub 2009 Aug 2.
The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy.
Sixty-one children (age <16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time.
Patients were aged 1-16 years (mean 7.5 + or - 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group.
Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.
这项前瞻性随机研究的目的是比较口服与静脉注射咪达唑仑在为小儿上消化道（GI）内镜检查提供镇静作用时的安全性和有效性。
对61例计划进行上消化道内镜检查的儿童（年龄<16岁）进行了研究。患者被随机分配接受口服或静脉注射咪达唑仑。对生命体征、镇静水平、检查前后的舒适度、内镜检查期间的焦虑程度、与父母分离的难易程度、操作的难易程度和持续时间以及恢复时间进行测量并比较。
患者年龄为1 - 16岁（平均7.5±3.42岁）；30例患者接受口服药物治疗，31例接受静脉注射药物治疗。两组之间在年龄或性别上无统计学显著差异。在镇静水平、与父母分离的难易程度、操作过程中监测患者的难易程度、心率、收缩压或呼吸频率方面无显著差异。在内镜取出后10分钟和30分钟时，静脉注射组的血氧饱和度显著低于口服组，且口服组的恢复时间比静脉注射组长。
口服咪达唑仑是一种安全有效的镇静方法，可显著降低焦虑程度，并提高接受食管胃十二指肠镜检查儿童的总体耐受性。
