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Sebghatollahi V, Tabesh E, Gholamrezaei A, et al. Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam. J Res Med Sci. 2017;22:133doi: 10.4103/jrms.JRMS_432_17.
Sebghatollahi, V., Tabesh, E., Gholamrezaei, A., Zandi, A. R., Minakari, M., & Shavakhi, A. (2017). Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 22133. https://doi.org/10.4103/jrms.JRMS_432_17
Sebghatollahi, Vahid, et al. "Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam." Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences vol. 22 (2017): 133. doi: https://doi.org/10.4103/jrms.JRMS_432_17
Sebghatollahi V, Tabesh E, Gholamrezaei A, Zandi AR, Minakari M, Shavakhi A. Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam. J Res Med Sci. 2017 Dec 26;22:133. doi: 10.4103/jrms.JRMS_432_17. eCollection 2017. PMID: 29387120; PMCID: PMC5767812.
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J Res Med Sci. 2017 Dec 26;22:133. doi: 10.4103/jrms.JRMS_432_17. eCollection 2017.

Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam.

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

Vahid Sebghatollahi, Elham Tabesh, Ali Gholamrezaei, Amir Reza Zandi, Mohammad Minakari, Ahmad Shavakhi

Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran.
  2. Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
  3. Medical Student's Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

PMID: 29387120 PMCID: PMC5767812 DOI: 10.4103/jrms.JRMS_432_17

Abstract

BACKGROUND: Premedication with orally administered benzodiazepines is effective in reducing anxiety and discomfort related to endoscopic procedures. We evaluated the efficacy and safety of oral midazolam in comparison to sublingual alprazolam as premedication for esophagogastroduodenoscopy (EGD).

MATERIALS AND METHODS: Adult candidates for diagnostic EGD received either oral midazolam (7.5 mg in 15 cc apple juice) or sublingual alprazolam (0.5 mg) 30 min before EGD. Procedural anxiety and pain/discomfort were assessed using 11-point numerical rating scales. Patients' overall tolerance (using a four-point Likert scale) and willingness to repeat the EGD, if necessary, were also assessed. Blood pressure, heart rate, and arterial oxygen saturation were monitored from medication to 30 min after the procedure.

RESULTS: Patients experienced a similar reduction in procedural anxiety after medication with oral midazolam and sublingual alprazolam; mean (standard deviation [SD] of 1.86 [1.63] and 2.02 [1.99] points, respectively,

CONCLUSION: Oral midazolam and sublingual alprazolam are equally effective in reducing EGD-related anxiety; however, EGD-related pain/discomfort is lower with alprazolam. Both benzodiazepines are equally safe and can be used as premedication for patients undergoing diagnostic EGD.

Keywords: Anxiety; benzodiazepines; endoscopy; esophagogastroduodenoscopy; premedication; sedation

Conflict of interest statement

There are no conflicts of interest.

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