MIDAZOLAM VERSUS DIAZEPAM IN LIPID EMULSION AS CONSCIOUS SEDATION FORCOLONOSCOPY WITH OR WITHOUT REVERSAL OF SEDATION WITH FLUMAZENIL

Background: The efficacy and tolerance of midazolam (Dormicum R) versu s diazepam in lipid emulsion (Diazemuls R, Dumex) was evaluated in a r andomized, controlled, double-blind trial in 200 patients undergoing t otal colonoscopy. Methods: Diazepam in a dosage of 11.2 +/- 2.3 mg and midazolam in a dosage of 5.3 +/- 1.1 mg were given over 2 minutes. Fl umazenil in a dosage of 0.2 mg within 15 seconds was administered to 5 0% of patients after procedure. Results: Diazepam and midazolam were e quivalent as judged by sedation, recovery time, patient tolerance, and ease of examination. The effect of flumazenil (Anexate R, Roche) on t he recovery time was not significant as most patients were fully awake by the end of the procedure. Midazolam induced significantly more amn esia, and the score for recall of the pain score was significantly les s after 14 days in the midazolam group. There were only minor complica tions in both groups. Conclusions: We conclude that midazolam can be u sed safely in relatively fit patients between 17 and 65 years old and that it is the drug of choice if amnesia is desirable. As sole premedi cation this drug was insufficient in 42% of the patients (pain score w as greater than 3), especially in young women.