https://scholars.lib.ntu.edu.tw/handle/123456789/161745
標題: | Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy | 作者: | Hsu, Yen-Hsuan FENG-SHENG LIN Yang, Chi-Cheng CHIH-PENG LIN Hua, Mau-Sun WEI-ZEN SUN |
關鍵字: | cognitive function;endoscopy;midazolam;reliable change index | 公開日期: | 2015 | 起(迄)頁: | 489-497 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | 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. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/279256 | DOI: | 10.1016/j.jfma.2013.07.018 10.1016/j.jfma.2013.07:018 |
SDG/關鍵字: | midazolam; hypnotic sedative agent; intravenous anesthetic agent; midazolam; adult; age distribution; annoyance; anxiety; Article; assessment of humans; attention; clinical article; cognition; cognitive defect; colonoscopy; controlled study; drug dose titration; drug safety; executive function; fatigue; female; human; learning; light sedation; low drug dose; male; middle aged; motivation; neuropsychological test; orientation; prospective study; psychomotor performance; reliable change index; sedation; university hospital; working memory; case control study; chemically induced; cognition; Cognition Disorders; psychological rating scale; regression analysis; short term memory; Taiwan; Anesthetics, Intravenous; Attention; Case-Control Studies; Cognition; Cognition Disorders; Colonoscopy; Female; Humans; Hypnotics and Sedatives; Learning; Male; Memory, Short-Term; Midazolam; Middle Aged; Neuropsychological Tests; Prospective Studies; Psychiatric Status Rating Scales; Regression Analysis; Taiwan |
顯示於: | 腦與心智科學研究所 |
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