• Isr Med Assoc J · May 2023

    Efficacy of Low Doses of Midazolam in Combination with Verbal Sedation during Transesophageal Echocardiography.

    • Marina Leitman, Isabella Pilcha, Vladimir Tyomkin, and Zoe Haitov.
    • Department of Cardiology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    • Isr Med Assoc J. 2023 May 1; 25 (5): 332335332-335.

    BackgroundTraditionally, transesophageal echocardiography (TEE) has been performed under moderate sedation and local pharyngeal anesthesia. Respiratory complications during the TEE can occur.ObjectivesTo test the effectiveness of low-dose midazolam combined with verbal sedation during TEE.MethodsThe study comprised 157 consecutive patients who underwent TEE under mild conscious sedation. All patients received local pharyngeal anesthesia and low doses of midazolam combined with verbal sedation. The course of TEE and clinical characteristics of the patients were analyzed.ResultsThe mean age was 64 ± 15.3 years, 96 males (61%). In 6% of the patients, low dose midazolam in combination with verbal sedation was insufficient and propofol was administrated. In women under 65 years of age with normal renal function, there was a 40% risk of low-dose midazolam being ineffective (P = 0.0018).ConclusionsIn most patients, TEE can be conducted easily using low-dose midazolam combined with verbal sedation. Some patients need deeper sedation with anesthetic agents like propofol. These patients tended to be younger, in good general health, and more often female.

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