Midazolam dose is associated with recurrence of paradoxical reactions during endoscopy

Table 2 Univariable analysis of procedure-related factors for recurrent paradoxical reactions

	Non-recurrent group (n = 250)	Recurrent group (n = 111)	P value
Endoscope type, n (%)			0.0765
H260	157 (62.8)	59 (53.64)
H290	90 (36)	51 (46.36)
Endoscopist experience, n (%)			0.4251
Less experienced	75 (30)	41 (36.94)
Expert	106 (42.4)	43 (38.74)
Highly expert	69 (27.6)	27 (24.32)
Midazolam dose (mean ± SD)
Initial (mg)	3.98 ± 1	4.19 ± 1.16	0.1804
Initial (mg/kg)	0.06 ± 0.02	0.06 ± 0.02	0.4070
Total (mg)	5.49 ± 2.04	6.74 ± 2.58	< 0.0001
Total (mg/kg)	0.08 ± 0.04	0.1 ± 0.04	< 0.0001
Midazolam dose administered in previous endoscopy1 (mean ± SD)
Initial (mg)	3.78 ± 0.95	3.84 ± 1.04	0.7277
Initial (mg/kg)	0.06 ± 0.02	0.06 ± 0.02	0.8448
Total (mg)	7.43 ± 2.79	7.4 ± 2.37	0.6087
Total (mg/kg)	0.11 ± 0.05	0.11 ± 0.04	0.4360
Δ Midazolam dose difference (total) (mg)
Median value (quartile 25%, 75%)	-2 (-3, 0)	-1 (-2, 1)	< 0.0001

¹All participants showed paradoxical responses to midazolam in previous endoscopies. Δ Midazolam dose difference = midazolam dose (mg) - previous midazolam dose (mg). Endoscopist experience was defined as: Less experienced, < 10 years (n = 14); expert, 10-15 years (n = 9); highly expert, > 15 years (n = 7). SD: Standard deviation.