Midazolam versus diazepam as premedication for upper gastrointestinal endoscopy: a randomized, double-blind, crossover study.

The effectiveness of midazolam as premedication for upper gastrointestinal endoscopy was examined and compared with that of diazepam in a double-blind crossover study involving 23 patients. The degree of sedation and cooperation of patients during the procedure and the speed of recovery from sedation were comparable for the two drugs. The effects of both compounds on arterial blood pressure and heart rate were quite similar. However, midazolam induced significantly more amnesia than diazepam (91% vs. 39%). Also, patients' acceptability for the procedure was significantly higher in the midazolam than in the diazepam group (78% vs. 26%). Therefore, when amnesia is desirable, as in the case of repeated endoscopies, midazolam should be the drug of choice.