{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:43:55Z","timestamp":1747190635193,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Interventional Cardiology"],"published-print":{"date-parts":[[2021,8,2]]},"abstract":"<jats:p>Objective. We aimed to study the differences in perception of pain during cardiac catheterization with midazolam monotherapy compared to the current standard of midazolam plus fentanyl. Background. Procedural sedation is important to ensure comfort and safety in patients undergoing left heart catheterization. Despite the widespread use of midazolam and fentanyl for procedural sedation, the effectiveness of this dual agent approach to sedation has never been studied in comparison to midazolam monotherapy. Methods. A total of 129 patients undergoing sedation for outpatient elective cardiac catheterization were randomly assigned to either midazolam monotherapy (n\u2009=\u200969) or combination of midazolam and fentanyl (n\u2009=\u200960). The primary outcome was assessment of pain perception prior to discharge by patient completion of a pain questionnaire. Participants were asked if they experienced any pain during their procedure (yes\/no) and, if yes, asked to rate their overall pain level using a 10-point Likert scale that ranged from 1 (minimal pain) to 10 (worst pain imaginable). Results. Most patients (n\u2009=\u200994, 73%) reported no pain during their procedure. Patients sedated with midazolam monotherapy reported similar average pain scores compared to patients sedated with the combination of midazolam and fentanyl (1.1 vs. 1.1, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.95<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). Conclusions. Among patients undergoing elective cardiac catheterization, no significant differences in pain scores were noted between sedation with midazolam alone compared to midazolam and fentanyl. Due to fentanyl\u2019s unfavorable interaction with P2Y12 agents, increased costs, and addiction potential, it is imperative that cardiologists revisit the role of effective procedural sedation with a single agent and avoid the use of fentanyl.<\/jats:p>","DOI":"10.1155\/2021\/9932171","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T21:35:08Z","timestamp":1628026508000},"page":"1-6","source":"Crossref","is-referenced-by-count":2,"title":["Old Is (Not) Gold: Midazolam Monotherapy versus Midazolam Plus Fentanyl for Sedation during Cardiac Catheterization"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4865-6124","authenticated-orcid":true,"given":"William","family":"Black","sequence":"first","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4396-5203","authenticated-orcid":true,"given":"Raj","family":"Baljepally","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laylan","family":"Shali","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Alsharif","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Warden","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Heidel","sequence":"additional","affiliation":[{"name":"University of Tennessee Medical Center, Heart Lung Vascular Institute, Department of Cardiology, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1207-5379","authenticated-orcid":true,"given":"Xiaopeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"doi-asserted-by":"publisher","key":"1","DOI":"10.1002\/ccd.26551"},{"doi-asserted-by":"publisher","key":"2","DOI":"10.1016\/j.gie.2014.07.062"},{"doi-asserted-by":"publisher","key":"3","DOI":"10.1097\/00000542-200204000-00031"},{"doi-asserted-by":"publisher","key":"4","DOI":"10.1111\/j.1540-8183.2001.tb00725.x"},{"doi-asserted-by":"publisher","key":"5","DOI":"10.1111\/j.1540-8167.1996.tb00531.x"},{"doi-asserted-by":"publisher","key":"6","DOI":"10.1111\/pace.12370"},{"doi-asserted-by":"publisher","key":"7","DOI":"10.1053\/j.jvca.2010.11.006"},{"doi-asserted-by":"publisher","key":"8","DOI":"10.1016\/j.cjca.2014.03.034"},{"doi-asserted-by":"publisher","key":"9","DOI":"10.1001\/jama.284.4.423b"},{"doi-asserted-by":"publisher","key":"10","DOI":"10.1001\/jamasurg.2019.2104"},{"doi-asserted-by":"publisher","key":"11","DOI":"10.1001\/jamapsychiatry.2018.3126"},{"doi-asserted-by":"publisher","key":"12","DOI":"10.1176\/appi.ajp.2015.15020262"},{"doi-asserted-by":"publisher","key":"13","DOI":"10.1001\/jamanetworkopen.2018.7621"},{"doi-asserted-by":"publisher","key":"14","DOI":"10.1007\/s00213-005-2155-0"},{"doi-asserted-by":"publisher","key":"15","DOI":"10.15585\/mmwr.mm6610a1"},{"doi-asserted-by":"publisher","key":"16","DOI":"10.1016\/j.annemergmed.2014.11.015"},{"doi-asserted-by":"publisher","key":"17","DOI":"10.1016\/j.annemergmed.2018.06.003"},{"doi-asserted-by":"publisher","key":"18","DOI":"10.1093\/eurheartj\/ehy016"},{"doi-asserted-by":"publisher","key":"19","DOI":"10.1161\/cir.0b013e3182742cf6"},{"issue":"24","key":"20","first-page":"e139","article-title":"AHA\/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American college of cardiology\/American heart association task force on practice guidelines","volume":"64","author":"E. 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