Midazolam as a sedative in esophageal manometry: a study of the effect on esophageal motility.

Midazolam 0.5 mg/kg was given intravenously as a sedative to 19 infants and children undergoing esophageal manometry after oral choral hydrate treatment. The lower esophageal sphincter pressure and motility were measured by manometry before and after midazolam injection. Midazolam did not change the lower esophageal sphincter pressure, blood pressure and respiratory rate of the subjects (p greater than 0.18), and the motility patterns. However, the mean heart rate increased by 5 beats/min after midazolam injection (p less than 0.05). One infant developed transient apnea, reversed promptly by intravenous flumazenil. Sedation occurred within 1 min after intravenous injection of the drug. No other side effects were noted. Midazolam is a relatively safe and effective sedative for accurate lower esophageal sphincter pressure measurement and esophageal manometry when a mild sedative such as choral hydrate does not work.