Trinchet J C, Beaugrand M, Bars L, Huet B, Ferrier J P
Presse Med. 1985 Sep 21;14(31):1649-51.
Upper gastrointestinal endoscopy is routinely used to follow up patients with digestive disease. The influence of premedication with diazepam on the procedure and on patients' acceptance of a second endoscopy was evaluated in a double-blind trial conducted on 81 patients randomized to 3 types of intravenous premedication: placebo (group A, 29 patients), diazepam 5 mg (group B, 27 patients) and diazepam 10 mg (group C, 25 patients). Endoscopy was performed under unfavourable conditions (refusal or agitation) in 12, 4 and 1 patients respectively of groups A, B and C (P less than 0.02). Out of 65 patients questioned one month later, 1 (group A) sternly refused a second endoscopy, 10 accepted unreservedly (O in group A, 4 in group B, 6 in group C; P less than 0.05 between A and C) and 54 accepted reluctantly. To find out whether diazepam was beneficial by impairing memory, a memory score on duration of the procedure was established; there were no significant differences between the three groups (P less than 0.001), but they did not correlate with the patients' acceptance of a second endoscopy. It is concluded that premedication with diazepam 10 mg i.v. makes upper gastrointestinal endoscopy easier to perform and facilitates acceptance of a repeat endoscopy 1 month later. This effect is probably independent of the impairment in memory induced by diazepam.
上消化道内镜检查常用于消化系统疾病患者的随访。在一项双盲试验中，对81例患者进行了评估，这些患者被随机分为3种静脉注射术前用药类型：安慰剂（A组，29例患者）、5毫克地西泮（B组，27例患者）和10毫克地西泮（C组，25例患者），以观察地西泮术前用药对操作过程以及患者接受第二次内镜检查的影响。A、B、C组分别有12例、4例和1例患者在不利条件下（拒绝或躁动）接受了内镜检查（P<0.02）。在一个月后接受询问的65例患者中，1例（A组）坚决拒绝第二次内镜检查，10例无保留地接受（A组0例，B组4例，C组6例；A组和C组之间P<0.05），54例勉强接受。为了确定地西泮是否通过损害记忆而有益，建立了关于操作持续时间的记忆评分；三组之间无显著差异（P<0.001），但它们与患者接受第二次内镜检查的情况无关。结论是静脉注射10毫克地西泮进行术前用药可使上消化道内镜检查更容易进行，并有助于患者接受1个月后的重复内镜检查。这种效果可能与地西泮引起的记忆损害无关。
