|Title:||Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy||Authors:||Hsu, Yen-Hsuan
|Keywords:||cognitive function;endoscopy;midazolam;reliable change index||Issue Date:||2015||Start page/Pages:||489-497||Source:||Journal of the Formosan Medical Association||Abstract:||
Background/Purpose: Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations.
Methods: We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of a health check-up were recruited. Neuropsychological testing on the full cognitive spectrum was evaluated at 15 minutes and 120 minutes after low-dose midazolam administration. The modified reliable change index (RCI) was used for intrapersonal comparisons and controlling for practice effects.
Results: Midazolam affected psychomotor speed (48%), memory (40%), learning (32%), working memory (17%), and sustained attention (11%), while sparing orientation and the fluency aspect of executive function at the acute stage. Residual memory (10%) and learning (10%) impairments at 2 hours after administration were evidenced in some patients. The three object recall and digit symbol coding tests can serve as useful screening tools.
Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state. Copyright (C) 2013, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
|Appears in Collections:||腦與心智科學研究所|
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