The Effects of Flumazenil on the Recovery Time and Satisfaction of the Use of Sedative Endoscopy with Midazolam / 대한소화기내시경학회지

BACKGROUND/AIMS: Treatment with flumazenil results in rapid reversal from sedation. In addition, the use of flumazenil can prevent accidents or memory loss after endoscopy. This study was conducted to evaluate the role of flumazenil according to dose. METHODS: A total of 150 consecutive outpatients were randomly allocated into three groups: patients given normal saline (control group), patients given 0.25 mg flumazenil (0.25 mg flumazenil group) and patients given 0.5 mg flumazenil (0.5 mg flumazenil group). Flumazenil or normal saline was injected 10 minutes after the completion of endoscopy. We evaluated the recovery time, time to discharge, patient satisfaction, and memory loss after discharge. RESULTS: The control group consisted of 44 subjects, the 0.25 mg flumazenil group consisted of 46 subjects and the 0.5 mg flumazenil group consisted of 45 subjects. The recovery time was significantly shorter in the two flumazenil groups as compared to the control group (28.5+/-15.0 min, 13.8+/-3.7 min, 12.4+/-1.7 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively)(p<0.001). The time to discharge after an examination was shorter in the flumazenil groups and showed dose-dependency (41.2+/-20.5 min, 22.1+/-10.9 min, 16.4+/-2.2 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively) (p<0.001). There was no significant difference in patient satisfaction among the three groups. The degree of memory recall was better in the 0.5 mg flumazenil group than in the other two groups (p<0.001). CONCLUSIONS: Flumazenil reversal of midazolam sedative endoscopy results in fast recovery and is helpful to minimize memory loss after an examination without interference of satisfaction.

Reproducibility of Percutaneous Sphincter of Oddi Manometry / 대한소화기내시경학회지

To assess the reproducibility of Sphincter of Oddi(SO) manometry, percutaneous manometry of SO was performed repeatedly in 10 subjects with biliary diseases(9 intrahepatic stone cases and 1 bile duct cancer case). Time interval for measurement of SO manometry was 3 to 7(mean 5) days. Mean manometric parameters of SO phasic contraction in the 1st and 2nd studies were not significantly different. However, as a result of manometric records, a diagnosis of dyskinesia was made in the 1st study from 4 patients(tachyoddia in 3 cases and increased retrograde propagation in one case). Among them, the diagnosis was reproduced in the 2nd study from 2(tachyoddia in 2 cases) out of 4 patients. In conclusion, abnormal manometric findings were poorly reproducible. Thus, more prolonged measurement of SO manometry or a dynamic test which stimuli or inhibit the SO activity may be necessary for accurate diagnosis of biliary dyskinesia and better reproducibility of SO manometry.