Sedation for ERCP with midazolam

Objective To assess the conscious sedative effect of midazolam during the procedure of ERCP, in terms of general stress responses of the patients, the circulatory change, tolerance, patient cooperation and safety during and after the procedure. Method One hundred twenty patients undergoing standard ERCP using the same model of endoscope. Each patient received intramuscular injection of midazolam at 0. 15mg/kg 20 min before starting the procedures. The sedative score (OAA/S) and the major vital signs (mean arterial pressure( MAP) ,heart rate(HR) and atrerial oxygen saturation (SpO2) ) were recorded during and after the endoscopic procedure. The degree of amnesia of the patients and the extent of satisfaction on both patient and physician sides were also assessed. Results The procedures were successfully completed in all patients. There was no significant change in MAP,HR and SpO2 in these patients. The adverse reactions to the procedures were significantly reduced. No signs of respiratory suppression was observed among this group of patients during and in the immediate post procedure period. Conclusion Conscious sedation by intramuscular injection of midazolam at a dose of 0. 15mg/kg 20min before the ERCP ameliorates the stress of the patients , maintained and steady hemodynamic condition for the procedure and an amnesia status after the procedure. Hence, midazolam is a satisfactory consions selative agent applicable in the ERCP examination.