Editorial
Choosing Sedation for Upper Endoscopy
Abstract
In this issue, Barriga1 describes a small randomized comparison of sedation by midazolam alone with sedation by midazolam plus fentanyl for uncomplicated diagnostic upper endoscopy. Like all good studies, this one raises as many questions as it answers.
The author studied patients undergoing nontherapeutic upper endoscopy who were relatively young (mean age 50) and healthy (all American Society of Anesthesiologists [ASA] I or ASA II) without any history of ethanol or other substance abuse. Although the authors do not mention airway anatomy, such as Mallampati scores, no patient weighed more than 210 pounds or had a head and neck history. Arterial oxygen saturations were all normal. Thus, the author's results may not extrapolate to older, sicker, or more complex patients.
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