{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T04:43:12Z","timestamp":1745815392092},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T00:00:00Z","timestamp":1358467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2013,7]]},"abstract":"Objectives<\/jats:title>Because of concerns regarding interactions between midazolam and antiretroviral therapy (ART<\/jats:styled-content>), alternative sedatives are sometimes used during procedural sedation. Our objective was to compare outcomes in patients on ART<\/jats:styled-content> who received intravenous (iv) midazolam vs.<\/jats:italic> iv diazepam, a second\u2010line agent, during colonoscopy.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a retrospective analysis of adult HIV<\/jats:styled-content>\u2010positive patients who underwent colonoscopy over a 3.5\u2010year period. Primary outcomes were sedation duration, nadir systolic blood pressure (SBP<\/jats:styled-content>), nadir oxygen saturation, abnormal cardiac rhythm, and change in level of consciousness using a standardized scale. We calculated rates of adverse events according to benzodiazepine use and identified risk factors for complications using univariate and multivariate analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>We identified 136 patients for this analysis: 70 received midazolam\u2010based sedation and 66 received a diazepam\u2010based regimen. There were no significant differences between the two groups with respect to sedation duration (mean 48.0 vs.<\/jats:italic> 45.7 minutes for the midazolam and diazepam groups, respectively; P<\/jats:italic>\u2009=\u20090.68), nadir SBP<\/jats:styled-content> (mean 97.0 vs.<\/jats:italic> 101.6 mmHg<\/jats:styled-content>; P<\/jats:italic>\u2009=\u20090.06), nadir oxygen saturation (mean 94.6 vs.<\/jats:italic> 94.8%; P<\/jats:italic>\u2009=\u20090.72) or rate of abnormal cardiac rhythm (11.4 vs.<\/jats:italic> 19.7%; P<\/jats:italic>\u2009=\u20090.18). More patients in the midazolam group experienced a depressed level of consciousness (91% vs.<\/jats:italic> 74% in the diazepam group; P<\/jats:italic>\u2009=\u20090.0075), but no patient required reversal of sedation or became unresponsive.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>We did not find evidence that patients who received midazolam for procedural sedation had clinical outcomes statistically different from those who received diazepam. These findings should be confirmed in prospective studies or in a randomized controlled trial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12014","type":"journal-article","created":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T12:12:44Z","timestamp":1358511164000},"page":"379-384","source":"Crossref","is-referenced-by-count":5,"title":["Safety of midazolam for sedation of HIV\u2010positive patients undergoing colonoscopy"],"prefix":"10.1111","volume":"14","author":[{"given":"ES","family":"Backman","sequence":"first","affiliation":[{"name":"Department of Pharmacy Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VA","family":"Triant","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Ehrenfeld","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Brigham & Women's Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Arpino","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Losina","sequence":"additional","affiliation":[{"name":"Harvard University Center for AIDS Research Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RT","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062360"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-4679(97)00022-X"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(99)70282-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0016-5107(03)00001-4"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.09.029"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9236(99)70051-2"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200645090-00001"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200038010-00003"},{"key":"e_1_2_6_10_1","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV\u20101 infected adults and adolescents.DHHS2008;1\u2013139."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atc.2004.06.001"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200342030-00002"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.20.6.549.35162"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199909000-00020"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1159\/000089577","article-title":"Sedative drug requirements during flexible bronchoscopy","volume":"72","author":"Chhajed PN","year":"2005","journal-title":"Respiration"},{"key":"e_1_2_6_16_1","doi-asserted-by":"crossref","unstructured":"RosarioCM KadievS NagarajaH DiazPT.Evaluating the safety of midazolam for procedural sedation in human immunodeficiency virus\u2010seropositive patients on protease inhibitors.ACCP Chest Conference Presentation. 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