Safety of intravenous midazolam and fentanyl for pediatric GI endoscopy: prospective study of 1578 endoscopies

Mamula, Petar; Markowitz, Jonathan E.; Neiswender, Kristin M.; Zimmerman, A.; Wood, S.; Garofolo, Michael; Nieberle, Megan; Trautwein, A.; Lombardi, Susan A.; Sargent-Harkins, Lynn; Lachewitz, Greta; Farace, Lisa; Morgan, Verita; Puma, Anita; Cook-Sather, Scott D.; Liacouras, Chris A.

doi:10.1016/j.gie.2006.05.002

Cited by 56 publications

(29 citation statements)

References 35 publications

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“…, in a study of children sedated with i.v. fentanyl and midazolam, noted mild or moderate adverse events including oxygen desaturation ≤92% for <20 s in 100 patients (9%), vomiting in 64 (5%), agitation in 15 (1%), oxygen desaturation 92% for >20 s in 12 (0.7%), and rash in eight (0.7%) 2 …”

Section: Discussionmentioning

confidence: 99%

“…As the frequency of pediatric gastrointestinal procedures has increased in recent years, the safety and efficacy of medications used for sedation during the procedure have received increased attention. The goals of sedation are generally threefold: cooperation, amnesia, and alleviation of anxiety 1,2 . The benefits of oral premedication for pediatric outpatient surgery and other diagnostic and therapeutic procedures include anxiolysis, reduced distress during i.v.…”

mentioning

confidence: 99%

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Use of oral midazolam in pediatric upper gastrointestinal endoscopy

Rafeey¹,

Ghojazadeh²,

Zadeh

et al. 2010

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Use of oral midazolam in pediatric upper gastrointestinal endoscopy

Rafeey¹,

Ghojazadeh²,

Zadeh

et al. 2010

Pediatrics International

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“…The safety of fentanyl and midazolam intravenous sedation was reported in a prospective study of 1,578 procedures (758 upper endoscopies, 116 colonoscopies, and 352 combined procedures)19). This study noted serious adverse events (apnea) in only 2 children.…”

Section: Sedation and Patient Monitoringmentioning

confidence: 91%

General considerations and updates in pediatric gastrointestinal diagnostic endoscopy

Kim

2010

Korean J Pediatr

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Gastrointestinal and colonic endoscopic examinations have been performed in pediatric patients in Korea for 3 decades. Endoscopic procedures are complex and may be unsafe if special concerns are not considered. Many things have to be kept in mind before, during, and after the procedure. Gastrointestinal endoscopy is one of the most frequently performed procedure in children nowadays, Since the dimension size of the endoscopy was modified for pediatric patients 15 years ago, endoscopic procedures are almost performed routinely in pediatric gastrointestinal patients. The smaller size of the scope let the physicians approach the diagnostic and therapeutic endoscopic procedures. But this is an invasive procedure, so the procedure itself may provoke an emergence state. The procedure-related complications can more easily occur in pediatric patients. Sedation-related or procedure-related respiratory, cardiovascular complications are mostly important and critical in the care. The endoscopists are required to consider diverse aspects of the procedure - patient preparation, indications and contraindications, infection controls, sedation methods, sedative medicines and the side effects of each medicine, monitoring during and after the procedure, and complications related with the procedure and medicines - to perform the procedure successfully and safely. This article presents some important guidelines and recommendations for gastrointestinal endoscopy through literature review.

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“…Endoscopy for infants has been conducted frequently with a combination of midazolam and fentanyl [3,4]. …”

Section: Sedation Policymentioning

confidence: 99%

Sedation under JCI standard

Kweon

2011

Korean J Anesthesiol

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The practice of anesthesia and sedation continues to expand beyond the operating room and now includes the gastroenterology suite, magnetic resonance imaging suites, and the cardiac catheterization laboratory. Non-anesthesiologists frequently administer sedation, in part because of a lack of available anesthesiologists and economic aspect, which emphasizes the safety of sedation. The Joint Commission International (JCI) set a standard responding to this issue indicating that qualified individuals who have drug and monitoring knowledge as well as airway management skills can only administer sedating agents. In Korea, the Ministry of Health and Welfare developed new sedation standards for hospital evaluation, which is similar to the JCI standards. This review intends to help with the understanding of the JCI sedation standard and compare it to the Korean sedation standard.

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Safety of intravenous midazolam and fentanyl for pediatric GI endoscopy: prospective study of 1578 endoscopies

Cited by 56 publications

References 35 publications

Use of oral midazolam in pediatric upper gastrointestinal endoscopy

Use of oral midazolam in pediatric upper gastrointestinal endoscopy

General considerations and updates in pediatric gastrointestinal diagnostic endoscopy

Sedation under JCI standard

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