소아에서 상부 위장관내시경 검사 시 Midazolam 투여에 따른 생명활력징후의 변화 및 진정 효과

Abstract

Purpose: Esophagogastroduodenoscopy (EGD) is a very useful procedure in diagnosing gastrointestinal diseases. However, there can be some difficulty in performing this procedure in children due to the associated discomfort. Recently, sedative agents such as midazolam have been introduced to alleviate this problem quite successfully. In our study, we attempted to confirm the safety and efficacy of midazolam use by monitoring the vital signs of children undergoing endoscopy. Methods: We analyzed data on 244 children who received EGD in the department of pediatrics at Severance Hospital, Yonsei University between August 2003 and July 2005. We evaluated O2 saturation, heart rate and change of mental status before and during the procedure and analyzed the results using the SPSS 12.0 package (Chi-square test, cross table method, etc.). Results: There was no significant difference in vital signs measured before and during EGD between midazolam treated and non treated children. There was no significant relationship between the amount of midazolam given and O2 saturation or a change of mental status. Regarding the O2 saturation, it was decreased during EGD in both groups with p＜0.01 though no difference was noted between the groups; the O2 level was maintained above 95% in all patients. The heart rate was also increased during EGD in both groups with a p＜0.01; however, no significant difference was noted between the groups. Conclusion: We confirmed the safety of low dose midazolam by evaluating the vital signs of children during endoscopies. However, the doses used were not sufficient for sedation or to obtain an amnestic effect.