From: Midazolam for sedation before procedures in adults and children: a systematic review update
Patient or population: Adults requiring sedation before gastrointestinal endoscopy and bronchoscopy, adults requiring nasogastric tube insertion in an emergency department and children Settings: Hospitals in India, Iran, UK, Portugal, USA and Japan Intervention: Intravenous midazolam Comparison: Placebo | ||||||
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Outcomes | Illustrative comparative risksa (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
Placebo | Intravenous midazolam | |||||
Level of sedation on a sedation assessment scale The Ramsay scale was used (numerical scale that ranged from 1 to 6 with higher scores indicating the participant was more sedated) | 1.19 | 1 Higher (from 0.6 higher to 1.4 higher | 100 (1 study) | Low1 ⊕⊕⊝⊝ | ||
Numeric rating of anxiety or number of participants rated as anxious Number of participants rated as anxious | 333 per 1000 | 143 per 1000 (30 to 663) | RR 0.43 (0.09 to 1.99) | 123 (2 studies) | low2 ⊕⊕⊝⊝ | |
Proportion of incomplete procedures or where there was difficulty performing the procedures | 216 per 1000 | 108 per 1000 (63 to 186) | RR 0.50 (0.29 to 0.86) | 223 (3 studies) | Low3 ⊕⊕⊝⊝ | |
Discomfort/pain | 168 per 1000 | 86 per 1000 (42 to 175) | RR 0.51 (0.25 to 1.04) | 190 (2 studies) | Low4 ⊕⊕⊝⊝ |