Skip to main content
SpringerLink
Log in

Midazolam anesthesia during rigid and flexible cystoscopy

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

The objective of this study was to investigate the usefulness and safety of midazolam-induced anesthesia for cystoscopy. From September 2005 to March 2006, 80 patients scheduled for regular outpatient follow-up cystoscopy participated in this study. The patients were randomized and classified according to the cystoscope type and midazolam use as follows: group 1 (10 men and 10 women), flexible cystoscopy + midazolam; group 2 (10 men and 10 women), flexible cystoscopy + no midazolam; group 3 (10 men and 10 women), rigid cystoscopy + midazolam; and group 4 (10 men and 10 women), rigid cystoscopy + no midazolam. Immediately after the procedure, the patients were asked to rate their comfort level using a ten-point visual linear analog self-assessment pain scale. The patients assigned in the midazolam group experienced no side-effects from the midazolam. Blood pressure and pulse rate did not change significantly during the procedure. The degree of pain experienced by group 1 was lower than other groups (P < 0.05) and group 4 had a significantly greater pain score than other groups (P < 0.05). No difference was evident between group 2 and 3 regarding the pain score. Midazolam anesthesia may relieve pain during rigid and flexible cystoscopy. Our findings suggest that midazolam anesthesia during cystoscopy is useful and safe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ross WA (1989) Premedication for upper gastrointestinal endoscopy. Gastrointest Endosc 35:120

    PubMed  CAS  Google Scholar 

  2. Whitwam JG, Al-Khudhairi D, McCloy RF (1983) Comparison of midazolam and diazepam in doses of comparable potency during gastroscopy. Br J Anaesth 55:773

    Article  PubMed  CAS  Google Scholar 

  3. Hanno PM, Wein AJ (1983) Anesthetic techniques for cystoscopy in men. J Urol 130:1070

    PubMed  CAS  Google Scholar 

  4. Forrest P, Galletly DC (1987) Comparison of propofol and antagonised midazolam anaesthesia for day-case surgery. Anaesth Intensive Care 15:394

    PubMed  CAS  Google Scholar 

  5. Johnson EW (2001) Visual analog scale (VAS). Am J Phys Med Rehabil 80:717

    Article  PubMed  CAS  Google Scholar 

  6. Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189

    Article  PubMed  CAS  Google Scholar 

  7. Kang YW, Na DL, Hahn SH (1997) Validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. Korean J Neurol Assoc 15:300

    Google Scholar 

  8. Gerecke M (1983) Chemical structure and properties of midazolam compared with other benzodiazepines. Br J Clin Pharmacol 16(Suppl 1):11S

    PubMed  Google Scholar 

  9. Pieri L (1983) Preclinical pharmacology of midazolam. Br J Clin Pharmacol 16(Suppl 1):17S

    PubMed  Google Scholar 

  10. Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ (1985) Midazolam: pharmacology and uses. Anesthesiology 62:3104

    Article  Google Scholar 

  11. Kanto JH (1985) Midazolam: the first water-soluble benzodiazepine. Pharmacology, pharmacokinetics and efficacy in insomnia and anesthesia. Pharmacotherapy 5:138

    PubMed  CAS  Google Scholar 

  12. Amrein R, Hetzel W (1991) Pharmacology of drugs frequently used in ICUs: midazolam and flumazenil. Intensive Care Med 17(Suppl 1):S1

    Article  PubMed  Google Scholar 

  13. Greenblatt DJ, Shader RI, Abernethy DR (1983) Drug therapy. Current status of benzodiazepines. N Eng J Med 309:410

    Article  CAS  Google Scholar 

  14. Study RE, Barker JL (1982) Cellular mechanisms of benzodiazepine action. JAMA 247:2147

    Article  PubMed  CAS  Google Scholar 

  15. Dundee JW, Wilson DB (1980) Amnesic action of midazolam. Anaesthesia 35:459

    Article  PubMed  CAS  Google Scholar 

  16. Koht A, Moss JI (1997) Does midazolam cause retrograde amnesia, and can flumazenil reverse that amnesia? Anesth Analg 85:211

    Article  PubMed  CAS  Google Scholar 

  17. Twersky RS, Hartung J, Berger BJ, McClain J, Beaton C (1993) Midazolam enhances anterograde but not retrograde amnesia in pediatric patients. Anesthesiology 78:51

    Article  PubMed  CAS  Google Scholar 

  18. Bulach R, Myles PS, Russnak M (2005) Double-blind randomized controlled trial to determine extent of amnesia with midazolam given immediately before general anaesthesia. Br J Anaesth 94:300

    Article  PubMed  CAS  Google Scholar 

  19. Herr HW (1990) Outpatient flexible cystoscopy and fulguration of recurrent superficial bladder tumors. Outpatient flexible cystoscopy and fulguration of recurrent superficial bladder tumors. J Urol 144:1365

    PubMed  CAS  Google Scholar 

  20. Herr HW, Schneider M (2001) Outpatient flexible cystoscopy in men: a randomized study of patient tolerance. J Urol 165:1971

    Article  PubMed  CAS  Google Scholar 

  21. Forster A, Gardaz JP, Suter PM, Gemperle M (1980) I.V. midazolam as an induction agent for anaesthesia a study in volunteers. Br J Anaesth 52:907

    Article  PubMed  CAS  Google Scholar 

  22. Ginsberg GG, Lewis JH, Gallagher JE, Fleischer DE, al-Kawas FH, Nguyen CC, Mundt DJ, Benjamin SB (1992) Diazepam versus midazolam for colonoscopy: a prospective evaluation of predicted versus actual dosing requirements. Gastrointest Endosc 38:651

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Soonchunhyang School of Medicine, Seoul, South Korea

    Yun Seob Song, Kong Jo Kim & Young Ho Park

  2. Department of Obstetrics and Gynecology, Inha School of Medicine, Incheon, South Korea

    Eun Seop Song

  3. Department of Urology, Seoul National University Hospital, 28, Yongon Dong, Jongno Ku, Seoul, 110-744, South Korea

    Ja Hyeon Ku

Authors
  1. Yun Seob Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eun Seop Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kong Jo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Ho Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ja Hyeon Ku
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ja Hyeon Ku.

Appendix

Appendix

1. Sedation scale

Alert (0)

Drowsy, partial lid closure (1)

Eyes closed, responding to verbal command (2)

Unresponsive to verbal command, but responsive to pain (3)

Unresponsive (4).

2. Visual analog pain scale

figure a

3. Recovery test (mini mental state examination)

Orientation for time (five points): what is the (year) (month) (date) (day) (season)?

Attention and calculation (five points): Serial 7’s. One point for each correct. Stop after five answer.

Language (three points): follow a three-stage command:

Take a paper in your right hand, fold it in half, and put it on the floor.

One point is given for each portion with a total of 13 points.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Song, Y.S., Song, E.S., Kim, K.J. et al. Midazolam anesthesia during rigid and flexible cystoscopy. Urol Res 35, 139–142 (2007). https://doi.org/10.1007/s00240-007-0091-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-007-0091-7

Keywords

Search

Navigation