Safety and effectiveness of midazolam for cirrhotic patients undergoing endoscopic variceal ligation.
Turk J Gastroenterol
; 29(4): 448-455, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-30249560
ABSTRACT
BACKGROUND/AIMS:
Endoscopic variceal ligation (EVL) is an established treatment for esophageal variceal bleeding. Midazolam (MDZ) is most commonly used for sedation during endoscopic procedures. However, adverse events (AEs) may occur more frequently in patients with cirrhosis due to altered MDZ metabolism. MATERIALS ANDMETHODS:
We retrospectively reviewed the records of 325 patients with cirrhosis who received EVL.RESULTS:
No significant differences were found in treatment outcome and procedure time among 151 patients in the MDZ group and 169 patients in the non-MDZ group. Desaturation (23.2% vs. 7.7%, p<0.01), bradycardia (22.5% vs. 17.2%, p=0.03), and hepatic encephalopathy (HE) (6.6% vs. 0.6%, p<0.01) were more common in the MDZ group than in the non-MDZ group. Logistic regression analyses revealed that an Eastern Cooperative Oncology Group (ECOG) score of ≥2 (p<0.01) and the use of MDZ (p<0.01) were associated with the development of overall AEs. An ECOG score of ≥2 (p=0.01), high serum creatinine level (p=0.02), and the use of MDZ (p<0.01) were significant risk factors for HE.CONCLUSION:
Extreme caution should be taken when sedating patients with cirrhosis receiving EVL due to the AEs associated with the use of MDZ.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Midazolam
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Varizes Esofágicas e Gástricas
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Hemorragia Gastrointestinal
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Hipnóticos e Sedativos
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Cirrose Hepática
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article