Oral Lorazepam is not Superior to Placebo for Lowering Stress in Children Before Digestive Endoscopy: A Double-Blind, Randomized, Controlled Trial

Chennou, F; Bonneau-Fortin, Alexanne; Portolese, Olivia; Belmesk, Lina; Jean-Pierre, M; Côté, Geneviève; Dirks, M; Jantchou, P

doi:10.1007/s40272-019-00351-9

Cited by 7 publications

(7 citation statements)

References 39 publications

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“…Por conseguinte, ao observar a percepção de dor durante a realização da endoscopia, verificou-se que os pacientes que receberam uma pré-medicação de lorazepam com sedação tanto pela combinação de midazolam e fentanil quanto pela associação de cetamina relataram significativamente menos dor quando comparados àqueles que não receberam lorazepam (CHENNOU et al, 2019). Os pacientes foram randomizados em quarto grupos, que receberam diferentes doses de cetamina (0 -0,25 -0,5 -1 mg/kg) seguida por uma mesma dose de propofol.…”

Section: Resultsunclassified

Efeitos dos sedativos utilizados no procedimento endoscópico e seus desfechos em pacientes pediátricos: uma revisão integrativa

Sales,

Hirata,

Costa

et al. 2024

PRW

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Objetivo: Realizar uma revisão de literatura para avaliar o tempo de recuperação, efeitos adversos, tempo de indução à sedação, dor durante e após o procedimento em pacientes pediátricos submetidos à endoscopia sedados por diferentes sedativos. Métodos: Trata-se de uma revisão integrativa conduzida de forma sistemática e sequencial, baseada na determinação e estruturação do tema, critérios de inclusão e seleção de 10 artigos na base de dados científicos "PubMed" para análise. Resultado: O tempo de recuperação não diferiu entre pacientes que receberam midazolam oral ou intravenoso, nem entre aqueles que receberam propofol com cetamina ou remifentanil. A administração de 0,1 mg/kg de dexametasona reduziu significativamente a incidência de náusea e vômitos pós-operatórios. O tempo de indução à sedação entre pacientes que receberam apenas propofol e aqueles que receberam propofol com dexmedetomidina foi indiferente. Os que receberam pré-medicação de lorazepam e sedação com midazolam e fentanil ou cetamina relataram menos dor em comparação com aqueles que não receberam lorazepam. Conclusão: Os achados sugerem a necessidade de delinear um protocolo que garanta uma sedação confortável e minimize eventos adversos e complicações na endoscopia pediátrica.

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Section: Resultsunclassified

Efeitos dos sedativos utilizados no procedimento endoscópico e seus desfechos em pacientes pediátricos: uma revisão integrativa

Sales,

Hirata,

Costa

et al. 2024

PRW

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“…In Fella Chennou et al ’s study of 101 children undergoing DE, although sublingual lorazepam did not affect patients’ preoperative stress, as measured by salivary cortisol; however, it was associated with a higher rate of comfortable procedures and temporary tachycardia was the most common intraoperative side effect in the lorazepam group. 6 Also, a randomized, double-blind trial was conducted to assess the sedative effect and enhancement in sedation quality of 1 mg orally administered lorazepam in patients who underwent endoscopic retrograde cholangiopancreatography. Their results did not show the beneficial effects of lorazepam as premedication.…”

Section: Discussionmentioning

confidence: 99%

“…Oral mucous membrane with its high vascularity accelerates drug absorption providing rapid onset of action, bypassing the first-pass metabolic process of the liver with more bioavailability of the drug; therefore, the low dosage makes high efficacy and decreased risk of side effects and increased patients' compliance and satisfaction. 4 Although propofol was shown to be the most effective sedative for both adults 5 and children, 6 benzodiazepine opioid combinations also remain prevalent. 6 Benzodiazepines are known for their anti-anxiety, hypnotic, muscle relaxant, and anticonvulsant effects.…”

Section: Introductionmentioning

confidence: 99%

“…4 Although propofol was shown to be the most effective sedative for both adults 5 and children, 6 benzodiazepine opioid combinations also remain prevalent. 6 Benzodiazepines are known for their anti-anxiety, hypnotic, muscle relaxant, and anticonvulsant effects. They accelerate the fixation of gamma-aminobutyric acid (GABA) on GABA type A receptors and increase the inhibitory properties of GABA.…”

Section: Introductionmentioning

confidence: 99%

“…Although propofol was shown to be the most effective sedative for both adults 5 and children, 6 benzodiazepine opioid combinations also remain prevalent. 6 Benzodiazepines are known for their anti-anxiety, hypnotic, muscle relaxant, and anti-convulsant effects.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the sedative effect of sublingual lorazepam versus placebo in patients underwent endoscopy: a double-blind, randomized controlled clinical trial

Hasanzarrini,

Nirumandi Jahromi,

Mohammad Salehi

et al. 2023

Clin Med Insights Gastroenterol

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Background: Digestive endoscopy (DE) is uncomfortable for most patients. Lorazepam is a potent benzodiazepine with anxiolytic and sedative effects. Objective: This study aims to determine the sedative effect of sublingual lorazepam versus placebo as a premedication in patients who underwent DE. Design: This is a mono-center, double-blind, and randomized controlled trial. Methods: A lorazepam sublingual tablet was made by researchers and physical tests were done on it, then the double-blind placebo-controlled trial was done to investigate the efficacy of 2 mg sublingually administered lorazepam as a premedication for endoscopy. Lorazepam or a placebo tablet was administered sublingually 30 min before the endoscopy. The patients, nurses, and physicians were blinded to the patient group. The depth of sedation was evaluated according to the American Society of Anesthesiology. Results: In all, 116 patients were randomly assigned to take either lorazepam ( n = 58) or a placebo ( n = 58). The results of physical properties tests were acceptable according to United States Pharmacopeia. There were no statistical differences between groups regarding age and gender. In the lorazepam group, 75.8% of patients showed mild sedation, and 24.2% of patients showed no sedation. All of the patients in the placebo had no sedation ( p = 0.001). Time of procedure ( p < 0.001), intraoperative O2 saturation ( p < 0.001), intraoperative heart rate ( p < 0.001), and intraoperative blood pressure ( p < 0.001) were significantly lower in the lorazepam group. No significant or dangerous side effects were observed except a bit of giddiness and dizziness. Conclusion: The results of this study showed that prescription of sublingual lorazepam 25–30 min before endoscopy provided mild sedation. Registration: IRCT201611039014N130 (05/11/2016); https://en.irct.ir/trial/9568 .

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Pediatric Personalized Anesthesia

Malekianzadeh

2020

Personalized Medicine in Anesthesia, Pain and Perioperative Medicine

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Oral Lorazepam is not Superior to Placebo for Lowering Stress in Children Before Digestive Endoscopy: A Double-Blind, Randomized, Controlled Trial

Cited by 7 publications

References 39 publications

Efeitos dos sedativos utilizados no procedimento endoscópico e seus desfechos em pacientes pediátricos: uma revisão integrativa

Efeitos dos sedativos utilizados no procedimento endoscópico e seus desfechos em pacientes pediátricos: uma revisão integrativa

Evaluation of the sedative effect of sublingual lorazepam versus placebo in patients underwent endoscopy: a double-blind, randomized controlled clinical trial

Pediatric Personalized Anesthesia

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