[Midazolam in ORL endoscopy in adults]

A prospective study was carried out in 20 selected subjects undergoing ENT endoscopy, with spontaneous ventilation of room air after premedication with midazolam IM 1.5 kg-10 [corrected] and then sedation with 0.07 mg.kg-1 IV and dextromoramide 0.03 mg.kg-1 IV and local anesthesia. The procedure was satisfactorily completed in the 20 cases; alertness was preserved in the 20 cases; total amnesia for the procedure was obtained in 19 cases. There were significant alterations in systolic blood pressure, heart rate and respiratory rate but these remained within strictly physiological limits. Blood gas results were similarly affected but at the limit of normal in 6 cases after 30 minutes of the procedure. Cardiovascular tolerance was excellent but close surveillance of the sedative effects on ventilation was required. Provided these conditions are respected, midazolam would appear to be of particular interest in ENT endoscopy.