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Early Phase 1 N=300 Randomized Double-blind Treatment

Sedation Regimens in GI Endoscopy

Anesthesia · Endoscopy · Colonoscopy · Conscious Sedation

Enrolled (actual)
300
Serious AEs
0.0%
Results posted
Apr 2024
Primary outcome: Primary: Pain Felt During the Procedure — 0.29; 0.30 score on a scale

Study Design & Population

Study type
Interventional
Phase
Early Phase 1
Interventions
midazolam alone (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Greg S Cohen MD LLC
Primary completion
Jul 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Pain Felt During the Procedure
0.29; 0.30
PRIMARY
Adequacy of Sedation
-0.28; -0.094
SECONDARY
Patient Reported Nausea
1; 1
SECONDARY
Adverse Events
1; 2
SECONDARY
Cecal Intubation Rate
152; 148
SECONDARY
Cecal Intubation Time
6.97; 7.99
SECONDARY
Colonoscopy Withdrawal Time
16.44; 16.29
SECONDARY
Adenoma Detection Rate
58; 54

Summary

This is a noninferiority study designed to examine whether conscious sedation with midazolam alone results in efficacy and safety that is not inferior to the combination of midazolam and fentanyl. English-speaking patients ≥18 years old and ≤75 years old presenting for GI endoscopy planned with conscious sedation using midazolam and fentanyl, will be randomized 1:1 to single agent sedation with midazolam or combination sedation with midazolam and fentanyl. Participants will be blinded to the choice of sedation. Sedation quality and adverse events will be measured with a validated patient-centered measure of procedural sedation quality, the PROcedural Sedation Assessment Survey (PROSAS) [Leffler, et al. Gastrointest Endosc. 2015;81(1):194-203]. Endoscopic quality measures in the 2 study groups will be collected by retrospective chart review, as an additional metric to ensure the quality of the procedure is not compromised by the choice of sedation.

Eligibility Criteria

Inclusion Criteria

  • English-speaking patients
  • Patients ≥18 years old and ≤75 years old
  • Outpatients presenting for EGD and/or colonoscopy planned with conscious sedation using midazolam and fentanyl
  • Patients presenting for endoscopic procedures with no GI fellow or trainee involvement in the procedure

Exclusion Criteria

  • Patients with an allergy or prior adverse event to either fentanyl or midazolam
  • Patients who have previously not tolerated endoscopy with conscious sedation and require monitored anesthesia care (MAC)
  • Adults unable to consent
  • Individuals who are not yet adults (infants, children, teenagers)
  • Pregnant women
  • Prisoners
  • Vulnerable populations, including cognitively impaired adults and adults who are otherwise unable to consent
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04807101). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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