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There are no clear conclusive clinical reports defining the adequate effective dose of midazolam in patients undergoing day-case esophageal-gastro-duodenoscopy (EGD). Defining such dosage will facilitate practitioners who are not anesthesia professionals to administer sedative drugs to establish a satisfactory level of moderate sedation. Our first aim is to determine the effective dose for 90% of patients (ED 90) of midazolam undergoing day-case EGD.
Midazolam is widely used in conscious sedation during esophageal-gastro-duodenoscopy (EGD) to increase patient's tolerance and cooperation. Its short duration, cardiorespiratory stability, anxiolytic and amnestic properties makes it the drug of choice for moderate sedation in day case short procedure 1. Therefore, moderate sedation during digestive endoscopy can be administered by endoscopist in safe monitored area while a qualified nurse monitors the level of consciousness and vital sings. The endoscopist's privileges to administer deeper alternative drug, i.e. propofol, might not be provided easily in many centers especially outside the hospital due to certain limitations. However, the patient's and endoscopist's satisfaction might not be achieved easily with the administration of midazolam for moderate sedation. Inappropriate dose will fail to produce amnesia or may cause respiratory side effect and delayed recovery and discharge. Therefore, there are no clear conclusive clinical reports defining the adequate effective dose of midazolam in patients undergoing day case EGD. This is obvious from different dosage used in various studies. In addition, midazolam dosage in adult is rarely based on the body weight during our daily clinical practice. Defining such dosage will facilitate practitioners who are not anesthesia professionals to administer sedative drugs to establish satisfactory level of moderate sedation. Our first aim is to determine the effective dose for 90% of patients (ED 90) of midazolam undergoing day case EGD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Midazolam | Other | Midazolam 2 mg as started dosage will be used for first patients and for the other patients will receive an predetermined dosage accordingly |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Midazolam injection | Drug | Midazolam 2mg iv to be used as starting dose using Biased coins up and down method (BCM) |
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| Measure | Description | Time Frame |
|---|---|---|
| Defining the ED90% of Midazolam for sedation of EGD | Calculating the effective Midazolam sedative dosage in 90% of patients undergoing EGD | 10 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| IRB IRB | Contact | +96613 844 2222 | 7093 | irb@kfsh.med.sa |
| Munir Bamadhaj, MD | Contact | +96613 844 2222 | 3993 | munir.bamdhaj@kfsh.med.sa |
| Name | Affiliation | Role |
|---|---|---|
| Ahed zeidan, MD | King Fahad Specialist Hospital Dammam | Study Director |
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Data will be collected inside the electronic system with limited access
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| ID | Term |
|---|---|
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
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Searching the ED90% of Midazolam using Biased coins method in 40 patients undergoing EGD
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The result be found out at the end of the study
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| D006571 | Heterocyclic Compounds |