PMID- 30249560
OWN - NLM
STAT- MEDLINE
DCOM- 20190212
LR  - 20210415
IS  - 2148-5607 (Electronic)
IS  - 1300-4948 (Print)
IS  - 1300-4948 (Linking)
VI  - 29
IP  - 4
DP  - 2018 Jul
TI  - Safety and effectiveness of midazolam for cirrhotic patients undergoing 
      endoscopic variceal ligation.
PG  - 448-455
LID - 10.5152/tjg.2018.17589 [doi]
AB  - 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 AND METHODS: 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.
FAU - Jo, Hee Bum
AU  - Jo HB
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Lee, Jun Kyu
AU  - Lee JK
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Jang, Dong Kee
AU  - Jang DK
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Kang, Hyoun Woo
AU  - Kang HW
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Kim, Jae Hak
AU  - Kim JH
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Lim, Yun Jeong
AU  - Lim YJ
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Koh, Moon-Soo
AU  - Koh MS
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
FAU - Lee, Jin Ho
AU  - Lee JH
AD  - Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk 
      University School of Medicine, Goyang, Korea.
LA  - eng
PT  - Journal Article
PL  - Turkey
TA  - Turk J Gastroenterol
JT  - The Turkish journal of gastroenterology : the official journal of Turkish Society 
      of Gastroenterology
JID - 9515841
RN  - 0 (Hypnotics and Sedatives)
RN  - R60L0SM5BC (Midazolam)
SB  - IM
CIN - Turk J Gastroenterol. 2020 Jan;31(1):75. PMID: 31258134
MH  - Aged
MH  - Esophageal and Gastric Varices/etiology/*surgery
MH  - Esophagoscopy/adverse effects/methods
MH  - Female
MH  - Gastrointestinal Hemorrhage/etiology/*surgery
MH  - Humans
MH  - Hypnotics and Sedatives/*adverse effects
MH  - Ligation/adverse effects/methods
MH  - Liver/metabolism
MH  - Liver Cirrhosis/complications/*metabolism
MH  - Logistic Models
MH  - Male
MH  - Midazolam/*adverse effects
MH  - Middle Aged
MH  - Postoperative Complications/*chemically induced
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC6284641
COIS- Conflict of Interest: The authors have no conflict of interest to declare.
EDAT- 2018/09/27 06:00
MHDA- 2019/02/13 06:00
PMCR- 2018/07/01
CRDT- 2018/09/26 06:00
PHST- 2018/09/26 06:00 [entrez]
PHST- 2018/09/27 06:00 [pubmed]
PHST- 2019/02/13 06:00 [medline]
PHST- 2018/07/01 00:00 [pmc-release]
AID - tjg-29-4-448 [pii]
AID - 10.5152/tjg.2018.17589 [doi]
PST - ppublish
SO  - Turk J Gastroenterol. 2018 Jul;29(4):448-455. doi: 10.5152/tjg.2018.17589.