Safety and effectiveness of midazolam for cirrhotic patients undergoing endoscopic variceal ligation

Hee Bum Jo, Jun Kyu Lee, Dong Kee Jang, Hyoun Woo Kang, Jae Hak Kim, Yun Jeong Lim, Koh Moon-Soo, Jin Ho Lee

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

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 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.

Original languageEnglish
Pages (from-to)448-455
Number of pages8
JournalTurkish Journal of Gastroenterology
Volume29
Issue number4
DOIs
StatePublished - Jul 2018

Keywords

  • Adverse events
  • Conscious sedation
  • Esophageal varices
  • Hepatic encephalopathy
  • Liver cirrhosis
  • Midazolam

Fingerprint

Dive into the research topics of 'Safety and effectiveness of midazolam for cirrhotic patients undergoing endoscopic variceal ligation'. Together they form a unique fingerprint.

Cite this